Objective: To investigate the efficacy, nursing characteristics, and management of different desensitization strategies before allogeneic hematopoietic stem cell transplantation (allo-HSCT) among patients with high level of human leukocyte antigen (HLA) antibodies. Methods: A retrospective analysis was conducted on 82 patients with high levels of HLA antibodies who underwent allo-HSCT at the First Affiliated Hospital of Soochow University and Suzhou Hopes Hematonosis Hospital between January 2020 to November 2023. Patients were divided into two groups based on the desensitization strategy they received: the anti-CD20 monoclonal antibody combined with therapeutic plasma exchange (TPE) group (n=50) and the anti-CD20 monoclonal antibody combined with Protein A immunoabsorption group (n=32). The differences of efficacy between the desensitization strategies were analyzed. The safety of both desensitization strategies were assessed by close monitoring of adverse events throughout the treatment. The nursing characteristics and interventions specific to these strategies were comprehensively summarized. Results: There were no significant differences in age, gender, and diagnosis between the two groups of patients receiving different desensitization strategies (P>0.05). Following desensitization in the immunoadsorption group, the mean fluorescence intensity (MFI) levels of anti-HLA Class I antibody decreased significantly compared to initial screening (P=0.048), while the decrease in MFI values of anti-HLA Class II antibody was not statistically significant (P=0.173). In the TPE group, the MFI levels for both anti-HLA Class I and II antibodies after desensitization decreased significantly compared to initial screening (P=0.025 and 0.028, respectively). Monitoring of adverse events during desensitization treatment, found that patients in the immunoadsorption group experienced mild decreases in blood pressure during the process, with two patients developing severe hypotension. No allergic reactions occurred, and no damage of liver or kidney function was observed after the immunoadsorption. In the immunoadsorption group, a total of 19 patients underwent sera immunoglobulin assays before and after immunoadsorption. Compared to the initial screening, the immunoglobulin G (IgG) levels significantly decreased after immunoadsorption (P<0.001). In TPE group, 12 patients experienced mild hypotension during the plasma exchange process, but no severe hypotension was observed. One patient developed an allergic reaction. After the TPE treatment, no damage of liver or kidney function was observed, nor any decrease of IgG levels. In terms of safety of intravenous access, neither group experienced severe complications such as catheter-related bloodstream infections or deep vein thrombosis. In the TPE group, catheter occlusion occurred during the process of plasma exchange in 2 patients, while no such incident was observed in the immunoadsorption group. Patients of both groups exhibited anxiety and depression before treatment. After psychological care, the scores for anxiety and depression significantly decreased (P<0.001). Conclusion: Both desensitization strategies significantly decreased the HLA antibodies in highly sensitized patients with high level of HLA antibodies undergoing allo-HSCT. For patients receiving immunoabsorption, nursing care should focus on preventing and managing hypotension and implementing infection-prevention measures due to IgG depletion. In contrast, for those undergoing TPE, vigilant monitoring and prompt management of potential allergic reactions are essential components of nursing practice.

To summarize the emergency nursing experience of 1 patient with neck suicide complicated with airway obstruction and hemorrhagic shock.Nursing points:to ensure airway safety and establish artificial airway;to optimize airway management and implement early sedation and wake-up;to control injury bleeding and limited fluid resuscitation;to establish a micro blood station in the emergency department and start a high-dose blood transfusion procedure;to carry out the refined target body temperature management to reduce complications;to optimize speech communication strategies and implement early psychological care.After 7 days of careful treatment and nursing,the patient's condition improved and recovered.After 2 months of follow-up,the patient recovered well.

Objective To construct a regional collaborative cloud-based treatment model treatment model for patients with severe road traffic injuries,and to preliminarily evaluate the differences in nursing timeliness indicators and outcomes.Methods The regional collaborative cloud-based treatment platform includes 4 ports,including public security traffic police,pre-hospital emergency center,regional trauma center triage,and regional trauma center resuscitation unit.This forms a standardized real-time interactive treatment process between regional medical services and police for patients with severe road traffic injuries.Using a concurrent control study design,241 patients with severe road traffic injuries admitted to the emergency department of a regional trauma center in Zhejiang Province from May 2022 to May 2024 were selected as the study subjects.Among them,120 patients treated with the regional real-time collaborative cloud-based treatment model were designated as an experimental group,while 121 patients treated with the original trauma care process were designated as a control group.The differences in timeliness indicators and outcomes between the 2 groups were compared.Results The study included 241 patients with severe trauma.After the application of the regional collaborative cloud-based treatment model,the time from the scene of the accident to the hospital,the proportion of information early waming,completion time of pre-examination and triage,waiting time of the trauma team,the time of the first CT,the length of multidisciplinary consultation,and the time for completing hospitalization procedures in the experimental group were shorter than those in the control group(P＜0.05),the proportion of information early waming in the experimental group was 100％(120/120),and the proportion of information early waming in the control group was 52.1％(63/121).The difference between the two groups was statistically significant(P＜0.001).The survival rate of the experimental group was 90.8％(109/120),and that of the control group was 86.0％(104/121).There was no significant difference between the two groups(x2=1.399,P=0.237).Conclusion The regional collaborative cloud-based treatment model improves the timeliness and standardization of the treatment of patients with severe road traffic injury,which has certain reference significance and promotion value.

This report summarizes the emergency care and nursing interventions for a Parkinson's disease patient with severe hypothermia complicated by ventricular arrhythmia.Key nursing points included continuous core temperature monitoring with goal-directed,phased,progressive rewarming;proactive identification and rapid response to arrhythmias;precise fluid management and skin protection to dynamically optimize blood perfusion and pressure redistribution;vigilant prevention and early intervention of hypothermia-related complications.With multidisciplinary treatment and meticulous nursing care,the patient was successfully discharged after 17 days of hospitalization with a favorable recovery.At the three-month follow-up after discharge,the patient had recovered well with no recurrence of similar episodes.

The paper introduces Professor SUN Shentian's experience in clinical practice of Ningshen (tranquilizing the mind) point. This point is an empirical point discovered by Professor SUN on the basis of meridian differentiation, nerve function and anatomic location, and in association with the years of clinical practice. The point is located in the prefrontal area, jointed with the distribution of the governor vessel, and responded to the body surface projection area of the frontal pole. It works on regulating the mind, regaining consciousness, improving cognition, alleviating depression, mutually treating physical and mental disorders, as well as unblocking collaterals, regulating the tendons and relieving spasm. This point is widely used in treatment of mental disorders, stroke and extrapyramidal diseases and obtains the reliable therapeutic effect in clinical practice.
Humans ; Acupuncture Points ; Acupuncture Therapy/history* ; China ; Meridians ; History, 20th Century

Objective:To construct a comprehensive nursing evaluation indicator system for HIV infected patients with hematological malignancies receiving chimeric antigen receptor T cell therapy, and provide theoretical support for clinical nursing practice.Methods:From November 2023 to February 2024, the first draft of indicator system was developed through literature review and panel meeting, experts from 6 provinces and cities were interviewed by Delphi consultations, and the final draft were formed by revision.Results:A total of 18 experts took part in the expert consultation, included 4 males and 14 females, aged (44.00 ± 7.24) years. The effective recovery rates of questionnaire for both rounds were 18/18, and the authority coefficient were 0.894 and 0.900, respectively. The coordination coefficients of the third level items were 0.146 and 0.128 respectively (both P<0.05) regarding the importance, and 0.156 ( P<0.05) regarding the operability. The final comprehensive nursing evaluation indicator system for HIV infected patients with hematological malignancies receiving chimeric antigen receptor T cell therapy consisted of 5 first-level items, 28 second-level items and 89 third-level items. Conclusions:The comprehensive nursing evaluation indicator system of CAR-T therapy for HIV infected patients with hematological malignancies is scientific, reliable and comprehensive, which can provide reference for clinical nurses in nursing practice and training related to CAR-T and AIDS.

Objective To construct a regional collaborative cloud-based treatment model treatment model for patients with severe road traffic injuries,and to preliminarily evaluate the differences in nursing timeliness indicators and outcomes.Methods The regional collaborative cloud-based treatment platform includes 4 ports,including public security traffic police,pre-hospital emergency center,regional trauma center triage,and regional trauma center resuscitation unit.This forms a standardized real-time interactive treatment process between regional medical services and police for patients with severe road traffic injuries.Using a concurrent control study design,241 patients with severe road traffic injuries admitted to the emergency department of a regional trauma center in Zhejiang Province from May 2022 to May 2024 were selected as the study subjects.Among them,120 patients treated with the regional real-time collaborative cloud-based treatment model were designated as an experimental group,while 121 patients treated with the original trauma care process were designated as a control group.The differences in timeliness indicators and outcomes between the 2 groups were compared.Results The study included 241 patients with severe trauma.After the application of the regional collaborative cloud-based treatment model,the time from the scene of the accident to the hospital,the proportion of information early waming,completion time of pre-examination and triage,waiting time of the trauma team,the time of the first CT,the length of multidisciplinary consultation,and the time for completing hospitalization procedures in the experimental group were shorter than those in the control group(P＜0.05),the proportion of information early waming in the experimental group was 100％(120/120),and the proportion of information early waming in the control group was 52.1％(63/121).The difference between the two groups was statistically significant(P＜0.001).The survival rate of the experimental group was 90.8％(109/120),and that of the control group was 86.0％(104/121).There was no significant difference between the two groups(x2=1.399,P=0.237).Conclusion The regional collaborative cloud-based treatment model improves the timeliness and standardization of the treatment of patients with severe road traffic injury,which has certain reference significance and promotion value.

Objective:To construct a comprehensive nursing evaluation indicator system for HIV infected patients with hematological malignancies receiving chimeric antigen receptor T cell therapy, and provide theoretical support for clinical nursing practice.Methods:From November 2023 to February 2024, the first draft of indicator system was developed through literature review and panel meeting, experts from 6 provinces and cities were interviewed by Delphi consultations, and the final draft were formed by revision.Results:A total of 18 experts took part in the expert consultation, included 4 males and 14 females, aged (44.00 ± 7.24) years. The effective recovery rates of questionnaire for both rounds were 18/18, and the authority coefficient were 0.894 and 0.900, respectively. The coordination coefficients of the third level items were 0.146 and 0.128 respectively (both P<0.05) regarding the importance, and 0.156 ( P<0.05) regarding the operability. The final comprehensive nursing evaluation indicator system for HIV infected patients with hematological malignancies receiving chimeric antigen receptor T cell therapy consisted of 5 first-level items, 28 second-level items and 89 third-level items. Conclusions:The comprehensive nursing evaluation indicator system of CAR-T therapy for HIV infected patients with hematological malignancies is scientific, reliable and comprehensive, which can provide reference for clinical nurses in nursing practice and training related to CAR-T and AIDS.

This report summarizes the emergency care and nursing interventions for a Parkinson's disease patient with severe hypothermia complicated by ventricular arrhythmia.Key nursing points included continuous core temperature monitoring with goal-directed,phased,progressive rewarming;proactive identification and rapid response to arrhythmias;precise fluid management and skin protection to dynamically optimize blood perfusion and pressure redistribution;vigilant prevention and early intervention of hypothermia-related complications.With multidisciplinary treatment and meticulous nursing care,the patient was successfully discharged after 17 days of hospitalization with a favorable recovery.At the three-month follow-up after discharge,the patient had recovered well with no recurrence of similar episodes.

To summarize the emergency nursing experience of 1 patient with neck suicide complicated with airway obstruction and hemorrhagic shock.Nursing points:to ensure airway safety and establish artificial airway;to optimize airway management and implement early sedation and wake-up;to control injury bleeding and limited fluid resuscitation;to establish a micro blood station in the emergency department and start a high-dose blood transfusion procedure;to carry out the refined target body temperature management to reduce complications;to optimize speech communication strategies and implement early psychological care.After 7 days of careful treatment and nursing,the patient's condition improved and recovered.After 2 months of follow-up,the patient recovered well.