Objective To develop a team collaborative protocol,based on the theory of the development of interprofessional collaborative team development(DICT),for early mobilisation of the patients with mechanical ventilation in the intensive care unit(ICU),hence to provide a standardised guidance on a multidisciplinary team with nurses as coordinators to implement the early mobilisation for ICU patients with mechanical ventilation and to improve the efficiency in patient mobilisation.Methods In September 2023,a preliminary draft of the collaborative team protocol based on ICTD was developed for early mobilisation of ICU patients with mechanical ventilation,based on literature review and current situation analysis.The status and influencing factors of multidisciplinary collaboration in early mobilisation for the patients with mechanical ventilation were identified.DICT framework was employed to develop the initial draft of protocol.From September to November 2023,Delphi expert consultation was employed and two rounds of expert consultation had been conducted before the final version of the protocol was drafted.Results A total of 21 experts participated in both rounds of consultation,with a 100.00%effective response rate of the questionnaires.Fifteen suggestions for modification were advised by the experts.The expert authority coefficient was 0.898,and the average coefficients of variation for the items from the two rounds of consultation were(0.14±0.05)and(0.12±0.06),respectively.The Kendall coordination coefficients for the two rounds were 0.198(P<0.001)and 0.256(P<0.001),respectively.The final protocol included 3 primary items(assessment and exploration,collaboration and integration,feedback and adjustment),13 secondary items and 57 tertiary items.Conclusion The team collaborative protocol for early mobilisation of ICU patients with mechanical ventilation,based on the DICT theory,is scientifically reliable.It provides a guidance and a reference for multidisciplinary teams in implementation of early mobilisation for ICU patients with mechanical ventilation..

Objective:To investigate the status of interdisciplinary training of nursing graduate students and the factors influencing their cognition of interdisciplinary training, and to provide a reference for cultivating innovative nursing talents.Methods:Using the convenient sampling method, an online questionnaire survey was conducted on the Wenjuanxing platform to investigate the current status of multidisciplinary training of nursing graduate students at 6 universities in Chengdu and Chongqing from January to March 2024. SPSS 22.0 software was used for t-test, one-way ANOVA, and multiple linear regression analysis. Results:This study collected 392 valid questionnaires, with 167 (42.60%) respondents reporting engagement in multidisciplinary research. The most common interdisciplinary areas included psychology (70, 41.92%), rehabilitation (59, 35.33%), and elderly care (55, 32.93%). Preferred training methods were research collaboration (341, 86.99%), student exchange or joint training programs (291, 74.23%), and interdisciplinary coursework (261, 66.58%). The main influencing factors for training effectiveness were multidisciplinary mentor team (314, 80.10%), teaching staff (287, 73.21%), and related course learning (278, 70.92%). The challenges in conducting multidisciplinary research included difficulties in acquiring interdisciplinary knowledge (327, 83.42%), high demands for knowledge integration capabilities (284, 72.45%), and a lack of training program (254, 64.80%). Interest in interdisciplinary research, course content involving interdisciplinary studies, and understanding of the interdisciplinary training model were identified as factors influencing the cognition of interdisciplinary training among nursing graduate students ( F=9.42, P<0.001; R2=0.146, adjusted R2=0.131). Conclusions:The multidisciplinary training of nursing graduate students remains in the exploratory stage. Universities should formulate multidisciplinary training programs for nursing graduate students, cultivate their interest in interdisciplinary research, establish cross-disciplinary courses integrating nursing with psychology, rehabilitation, and elderly care, assemble multidisciplinary mentor teams, and support research collaborations or joint training programs. These measures can enhance the comprehensive competencies and innovative capabilities of nursing graduate students.

Objective:To investigate the status of interdisciplinary training of nursing graduate students and the factors influencing their cognition of interdisciplinary training, and to provide a reference for cultivating innovative nursing talents.Methods:Using the convenient sampling method, an online questionnaire survey was conducted on the Wenjuanxing platform to investigate the current status of multidisciplinary training of nursing graduate students at 6 universities in Chengdu and Chongqing from January to March 2024. SPSS 22.0 software was used for t-test, one-way ANOVA, and multiple linear regression analysis. Results:This study collected 392 valid questionnaires, with 167 (42.60%) respondents reporting engagement in multidisciplinary research. The most common interdisciplinary areas included psychology (70, 41.92%), rehabilitation (59, 35.33%), and elderly care (55, 32.93%). Preferred training methods were research collaboration (341, 86.99%), student exchange or joint training programs (291, 74.23%), and interdisciplinary coursework (261, 66.58%). The main influencing factors for training effectiveness were multidisciplinary mentor team (314, 80.10%), teaching staff (287, 73.21%), and related course learning (278, 70.92%). The challenges in conducting multidisciplinary research included difficulties in acquiring interdisciplinary knowledge (327, 83.42%), high demands for knowledge integration capabilities (284, 72.45%), and a lack of training program (254, 64.80%). Interest in interdisciplinary research, course content involving interdisciplinary studies, and understanding of the interdisciplinary training model were identified as factors influencing the cognition of interdisciplinary training among nursing graduate students ( F=9.42, P<0.001; R2=0.146, adjusted R2=0.131). Conclusions:The multidisciplinary training of nursing graduate students remains in the exploratory stage. Universities should formulate multidisciplinary training programs for nursing graduate students, cultivate their interest in interdisciplinary research, establish cross-disciplinary courses integrating nursing with psychology, rehabilitation, and elderly care, assemble multidisciplinary mentor teams, and support research collaborations or joint training programs. These measures can enhance the comprehensive competencies and innovative capabilities of nursing graduate students.

Objective To develop a team collaborative protocol,based on the theory of the development of interprofessional collaborative team development(DICT),for early mobilisation of the patients with mechanical ventilation in the intensive care unit(ICU),hence to provide a standardised guidance on a multidisciplinary team with nurses as coordinators to implement the early mobilisation for ICU patients with mechanical ventilation and to improve the efficiency in patient mobilisation.Methods In September 2023,a preliminary draft of the collaborative team protocol based on ICTD was developed for early mobilisation of ICU patients with mechanical ventilation,based on literature review and current situation analysis.The status and influencing factors of multidisciplinary collaboration in early mobilisation for the patients with mechanical ventilation were identified.DICT framework was employed to develop the initial draft of protocol.From September to November 2023,Delphi expert consultation was employed and two rounds of expert consultation had been conducted before the final version of the protocol was drafted.Results A total of 21 experts participated in both rounds of consultation,with a 100.00%effective response rate of the questionnaires.Fifteen suggestions for modification were advised by the experts.The expert authority coefficient was 0.898,and the average coefficients of variation for the items from the two rounds of consultation were(0.14±0.05)and(0.12±0.06),respectively.The Kendall coordination coefficients for the two rounds were 0.198(P<0.001)and 0.256(P<0.001),respectively.The final protocol included 3 primary items(assessment and exploration,collaboration and integration,feedback and adjustment),13 secondary items and 57 tertiary items.Conclusion The team collaborative protocol for early mobilisation of ICU patients with mechanical ventilation,based on the DICT theory,is scientifically reliable.It provides a guidance and a reference for multidisciplinary teams in implementation of early mobilisation for ICU patients with mechanical ventilation..

Objective:To describe and analyze suicide risk of patients with schizophrenia,major depressive disorder,and bipolar disorder.Methods:A total of 2 016 patients with schizophrenia,903 patients with major de-pressive disorder,and 381 patients with bipolar disorder from inpatients,clinics,or communities who met the diag-nostic criteria of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition were recruited.All patients were interviewed by psychiatrists using the Mini International Neuropsychiatric Interview to diagnose mental disor-ders and assess suicide risk,as well as Clinical-Rated Dimensions of Psychosis Symptom Severity(CRDPSS)to as-sess symptoms.Differences and risk factors of suicide risk among three types of mental disorders were explored u-sing multivariate logistic regression analysis.Results:In the past one month,37 patients with schizophrenia(1.8％),516 patients with major depressive disorder(57.1％),and 102 patients with bipolar disorder(26.8％)had suicide risk.Compared with patients with schizophrenia,suicide risk in patients with major depressive disorder(OR=36.50)and bipolar disorder(OR=20.10)increased.Female(OR=1.87),smoking(OR=1.76),family history of suicide(OR=5.09),higher score of CRDPSS hallucination(OR=1.80),and higher score of CRDPSS depression(OR=1.54)were risk factors of suicide risk of patients.Conclusions:Suicide risk of patients with ma-jor depressive disorder and bipolar disorder is higher than that of patients with schizophrenia.In clinical practice,it is important to regularly assess suicide risk of patients.Patients who experience symptoms of hallucination and de-pression should be paid more attention to.

Objective:To analyze the learning styles of intensive care specialist nurses and to explore the application effects of the teaching method based on Kolb's learning style theory in intensive care specialist nurse training.Methods:Nurses who participated in the intensive care specialist nurse training in Chongqing during 2022 and 2023 were selected as the research subjects. Among them, the 49 nurses from 2022 were assigned to the control group, while the 50 nurses from 2023 were assigned to the experimental group. Before the training, the Kolb's Learning Style Scale was used to investigate the two groups of nurses. A new training method based on different learning styles was used in the experimental group, while the conventional training method was used in the control group. The theory, clinical practice, and satisfaction scores were compared between the two groups after training. SPSS 21.0 was used for the t-test, chi-square test, or Fisher's exact test. Results:The learning styles of the two groups were similar, with the highest proportion observed in divergent type, followed by assimilation type, and the lowest proportions in convergent type and compliant type, albeit without significant differences. The experimental group showed higher scores of theory, clinical practice, and satisfaction compared to the control group [(77.20±8.34) vs. (80.38±5.50), t=-2.24, P=0.027; (93.73±1.83) vs. (95.31±1.07), t=-5.20, P<0.001; (20.57±2.09) vs. (22.62±1.61), t=-5.46, P<0.001] Conclusion:The teaching method based on Kolb's learning style theory can improve the theory and clinical practice scores and the overall satisfaction of nurses who participate in the intensive care specialist nurse training.

Objective:To anatomically study the external bone graft axis from the pedicle (canal) to the endplate designed for compression healing fractures of the anterior vertebral column in freshly dried vertebral specimens from T10 to L5.Methods:Eight groups of freshly dried vertebral specimens from T10 to L5 (128 vertebral bodies and 256 lateral pedicles and lateral vertebral bodies) were used to observe the vertebral axis of the pedicle (canal), the internal sagittal diameter of the pedicle (canal), and the sagittal diameter of the vertebral body, and the position of vertebral pedicle (canal) axis (f-angle) before design of the external bone graft axis from the pedicle (canal) to the endplate of the compression healing vertebral body. (1) The internal sagittal diameter of the pedicle (canal) was divided into 3 segments. The lateral segment of the vertebral plate was wide, the middle segment of the isthmus of the vertebral arch was narrow and the medial segment of the terminal segment of the vertebral arch was wide. The narrow isthmus of the middle arch (canal) was used as a transposition axis in the design of the axis of the bone graft from the vertebral arch (canal) to the endplate of the compression healing vertebral body. (2) The axis of the vertebral body of the pedicle (canal) was located medial to the transposition axis, parallel to the f-angle at 0° as described by Saillant G. (3) The compression degree of the vertebral body was measured at the outer edge of the lateral anterior column, with Ⅰ° for less than 1/4 compression of the anterior column of the vertebral body, Ⅱ° for 1/4 to 2/4, Ⅲ° for 2/4 to 3/4 and Ⅳ° for more than 3/4 of the compression. (4) The f-angle described by Salliant G at the entry end which was corresponding to the endplate of the compression healing vertebral body was used to design the pedicle (canal) to the outer implant axis of the endplate of the compression healing vertebral body.Results:At an f-angle of 8° to 10°, the bone graft axis was aligned with the Ⅱ° compression healing vertebral endplate on the superior endplate side of the vertebral body axis of the arch; at an f-angle of 16° to 18°, the bone graft axis corresponded to the superior endplate of the Ⅰ° compression healing vertebral body. At an f-angle of -10°~-8°, the bone graft axis corresponded to the Ⅲ° compression healing vertebral endplate on the inferior endplate side of the vertebral body axis of the arch; at an f-angle of -18°~-16°, the bone graft axis corresponded to the inferior endplate of the Ⅳ° compression healing vertebral body.Conclusions:The external axis from the pedicle (canal) to the endplate designed in the present anatomic study for compression healing fractures of the anterior vertebral column allows for safe and easy granular bone implantation due to the toughness of the cortical bone around the arch root (canal) in addition to the precise design of the bone graft axis from the pedicle to the endplate from T10 to L5.

Objective:To investigate the emergency surgical effect of ruptured intracranial dural arteriovenous fistula (DAVF).Methods:Patients with ruptured intracranial DAVF underwent microsurgery in the Department of Neurosurgery, Nanping First Hospital Affiliated to Fujian Medical University from May 2013 to July 2022 were retrospectively included. The clinical, imaging and follow-up data were collected, and the clinical characteristics, selection of surgical methods and treatment effects of patients were summarized.Results:A total of 8 patients with DAVF were enrolled. Their age ranged from 11 to 60 years (average, 48 years). There were 7 males and 1 female. All 8 patients suffered from intracranial hemorrhage, manifested as headache and vomiting in 2 cases, simple conscious disturbance in 2 cases, conscious disturbance with cerebral hernia in 3 cases, and conscious disturbance with limb paralysis in 1 case. The fistula was located in the anterior fossa in 4 cases (including 2 cases with aneurysms), the middle fossa in 2 cases (including 1 case with moyamoya disease), the transverse sinus in 1 case, and the anterior 1/3 area of the sagittal sinus in 1 case. Cognard classification: 7 patients were type Ⅲ and 1 was type Ⅳ. After admission, all patients underwent emergency craniotomy and microsurgery to remove hematoma. Among them, 4 patients underwent decompressive craniectomy at the same time, 1 patient with moyamoya disease underwent dural turnover and temporalis muscle application at the same time, and 2 patients with aneurysms at the same location were clipped at the same time. Postoperative re-examination of head CT showed that the hematoma was cleared satisfactorily and the midline was no shift in all 8 patients. CT angiography (CTA) showed that the fistula disappeared within 2 weeks. Seven patients were followed up within 1-12 months after operation. CTA or digital subtraction angiography showed no recurrence of DAVF. Two patients with aneurysms did not have residual or recurrent aneurysms. All patients had no new neurological symptoms, and the Glasgow Outcome Scale score in 2 patients increased by 1 compared with that at discharge.Conclusion:Emergency microsurgery is an effective method for the treatment of ruptured intracranial DAVF, especially for patients with special parts or complicated hematoma, cerebral hernia, and other vascular diseases.

Objective:To explore the efficacy of tracheotomy and nasal intubation in airways management in treatment of patients with respiratory failure caused by severe tetanus.Methods:A respective case series study was conducted to analyze the data of 92 patients with respiratory failure caused by severe tetanus admitted to Jiangxi Chest Hospital from January 2012 to December 2019. There were 60 males and 32 females, aged 23-81 years [(47.5±14.1)years]. Overall 43 patients underwent tracheotomy (tracheotomy group), and 49 patients underwent nasal intubation (nasal intubation group). The blood gas related indexes (PaO 2, PaCO 2), catheter retention time, incidence of complications such as airway bleeding, nasosinusitis, catheter blockage and ventilator-associated pneumonia (VAP), and clinical outcome were compared between the two groups. Results:After mechanical ventilation, the PaO 2 and PaCO 2 in both groups were significantly improved ( P<0.01), with no significant difference between groups ( P>0.05). Both groups were similar regarding the catheter indwelling time, catheter blockage, airway bleeding and nasosinusitis ( P>0.05). The incidences of VAP and catheter blockage after extubation in tracheotomy group [12%(5/43), 12%(5/43)] were significantly different from those in nasal intubation group [0%(0/49), 31%(15/49)] ( P<0.05). There were 3 deaths in each group, with the mortality rate of 7% (3/43) in tracheotomy group and of 6% (3/49) in nasal intubation group ( P>0.05). Both groups of live tetanus patients were cured. After 3-month follow-up, the tetanus was cured in the two groups. Conclusions:The tracheotomy and transnasal tracheal intubation are optional for severe tetanus patients with respiratory failure. The former has airway and tissue trauma, but it is convenient for mechanical ventilation management, especially indicated for patients with severe convulsions, angular arch reflexes, poor sedation, and continuous application of muscle relaxants. Nasal intubation is relatively non-invasive, simple and fast method, but the prevention and monitoring of VAP requires higher requirements.

Objective To explore the best way of rearing children guarded by welfare  in stitutions. Methods Grouping the rearing methods into two categories randomly, traditional orphanages and foster care, then using their height, weight, Gesell development schedules and Ages and Stages Questionnaires-Third Edition to compare their physical development, psychological health, behaviour, and cognition progress from the data collected when they were 12 months old in both categories. Results For children between age 0.5 month to 1.5 month old,  by comparing the data collected when they were 12 month old,  the study found that there was no statistical difference in physical development between these two groups of children in main indicators of height (t=0.94, P=0.349>0.05) and weight(t=1.843, P=0.068>0.05).  However, children in family foster care shown advantage in area of motor ability(t =2.102, P=0.037<0.05) ,  gross motor skill (t=2.566, P=0.011<0.05), fine motor skill (t=2.825,P=0.005<0.01), which had statistical significance. Foster care children also shown big advantage in area of cognitive ability (t=2.479 ,P=0.014<0.05), behaviour(t=2.535，P=0.012＜0.05), problem resolving ability(t=3.241, P=0.001<0.01), personal-social(t=3.173，P=0.001<0.01), the differences were statistically significant. Especially for verbal ability, foster care children had significant advantage in both measurements (t=6.329、4.886，P=0.000<0.01).  Conclusion Family foster care should be chosen as much as possible in rearing children whose guardians are welfare institutions.