Objective To explore the clinical value of artificial intelligence (AI) quantitative parameters in distinguishing pathological grades of stageⅠ invasive adenocarcinoma (IAC). Methods Clinical data of patients with clinical stageⅠ IAC admitted to Yantaishan Hospital Affiliated to Binzhou Medical University from October 2018 to May 2023 were retrospectively analyzed. Based on the 2021 WHO pathological grading criteria for lung adenocarcinoma, IAC was divided into gradeⅠ, grade Ⅱ, and grade Ⅲ. The differences in parameters among the groups were compared, and logistic regression analysis was used to evaluate the predictive efficacy of AI quantitative parameters for grade Ⅲ IAC patients. Parameters were screened using least absolute shrinkage and selection operator (LASSO) regression analysis. Three machine learning models were constructed based on these parameters to predict grade Ⅲ IAC and were internally validated to assess their efficacy. Nomograms were used for visualization. Results A total of 261 IAC patients were included, including 101 males and 160 females, with an average age of 27-88 (61.96±9.17) years. Six patients had dual primary lesions, and different lesions from the same patient were analyzed as independent samples. There were 48 patients of gradeⅠ IAC, 89 patients of grade Ⅱ IAC, and 130 patients of grade Ⅲ IAC. There were statitical differences in the AI quantitive parameters such as consolidation/tumor ratio (CTR), ect among the three goups. (P<0.05). Univariate analysis showed that the differences in all variables except age were statistically significant (P<0.05) between the group gradeⅠ+grade Ⅱand the group grade Ⅲ . Multivariate analysis suggested that CTR and CT standard deviation were independent risk factors for identifying grade Ⅲ IAC, and the two were negatively correlated. Grade Ⅲ IAC exhibited advanced TNM staging, more pathological high-risk factors, higher lymph node metastasis rate, and higher proportion of advanced structure. CTR was positively correlated with the proportion of advanced structures in all patients. This correlation was also observed in grade Ⅲ but not in gradeⅠand grade ⅡIAC. CTR and CT median value were selected by using LASSO regression. Logistic regression, random forest, and XGBoost models were constructed and validated, among which, the XGBoost model demonstrated the best predictive performance. Conclusion Cautious consideration should be given to grade Ⅲ IAC when CTR is higher than 39.48% and CT standard deviation is less than 122.75 HU. The XGBoost model based on combined CTR and CT median value has good predictive efficacy for grade Ⅲ IAC, aiding clinicians in making personalized clinical decisions.

Objective:To explore the effect of continuous nursing on the psychology and quality of life of patients with mild traumatic brain injury.Methods:A review of 120 patients with mild traumatic brain injury who were hospitalized in the Second Affiliated Hospital of Wenzhou Medical University from January 2016 to December 2019 were selected. According to the order of admission, sample numbers were drawn from the random number list and entered into groups. There were 60 cases in the control group and the intervention group. The control group received routine general nursing, and the intervention group received continuous nursing. The Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), and Quality of Life Scale (SF-36) were used to evaluate the psychology and quality of life of patients on the day of discharge and one week, one month, and three months after discharge.Results:There was no significant difference in the scores of HAMA, HAMD and SF-36 between the two groups on the day of discharge ( P>0.05). The HAMA scores at 1 week, 1 month and 3 months after the intervention of the intervention group were (18.2±8.6), (13.7±5.8) and (5.6±2.3), which were significantly lower than those of the control group (24.2±11.2), (20.4±8.2), (8.9±3.6), the differences were statistically significant ( t values were 2.32, 3.67, 4.13, P<0.05). The HAMD scores at 1 week, 1 month and 3 months after the intervention of the intervention group were (24.3±7.1), (10.9±4.2), (6.8±2.9), which were significantly lower than those of the control group (28.6±8.5), (15.3±8.3), (14.8±4.6), the differences were statistically significant ( t values were 2.11, 2.57, 7.99, P<0.05). The SF-36 scores at 1 week, 1 month and 3 months after the intervention of the intervention group were (77.2±8.9), (85.2±9.7), (87.8±12.9), which were significantly higher than those of the control group (72.3±8.2), (79.4±10.9), (81.0±11.5), the differences were statistically significant ( t values were -2.23, -2.14, -2.13, P<0.05). Conclusions:Continuing care can be extended to the patient's family, so that the health problems faced by the patient after discharge from the hospital can be effectively solved, relieve psychological pressure and improve the quality of life, and it is worthy of clinical application.

Objective:To establish the norm of the Chinese version of Karitane Parenting Confidence Scale (KPCS) in urban areas of China.Methods:From August to December 2017, the parents of 2 216 children (<36 months old) were selected from 15 cities (Beijing, Lianyungang, Hangzhou, Chengdu, Xi′an, Guangzhou, Changsha, Jinan, Guiyang, Ningbo, Dalian, Qinhuangdao, Maanshan, Chongqing and Wuhan) in 14 provinces by stratified random sampling. The general demographic characteristics and parents′ parenting confidence were collected by a self-made questionnaire and KPCS Chinese version. The percentile norm was established. P 3, P10 and P 25 were used as the criteria to define the degree of lack of parenting confidence. Results:The age of mothers was (30.67±4.29). The age of the father was (32.50±4.99) years old. There were 726 (32.76%), 759 (34.25%) and 731 (32.99%) infants in 6-12, 12-23 and 24-35 months old groups. The total scores of P 50, P 25, P 10 and P 3 of KPCS (Chinese version) of infant parents in urban areas in China were 41, 38, 33, and 29 respectively. When the scores of parents were 34-37, 30-33, and ≤ 29, they were judged as mild, moderate, and severe lack of parenting confidence. There was no significant difference in the Chinese version of KPCS between parents of different age groups and parents of different gender (χ2=3.53, P=0.171; χ2=1.41, P=0.236). Each factor score≤ P 3 is defined as the boundary score, and the corresponding boundary scores of "parenting" "support" and "competence" were 13, 9, and 5 respectively. Conclusion:The Chinese version of KPCS can be used to assess the parenting confidence of infants in urban areas of China. It can used as one of the bases for scientific and objective evaluation of the parenting status of families.

Objective:To establish the norm of the Chinese version of Karitane Parenting Confidence Scale (KPCS) in urban areas of China.Methods:From August to December 2017, the parents of 2 216 children (<36 months old) were selected from 15 cities (Beijing, Lianyungang, Hangzhou, Chengdu, Xi′an, Guangzhou, Changsha, Jinan, Guiyang, Ningbo, Dalian, Qinhuangdao, Maanshan, Chongqing and Wuhan) in 14 provinces by stratified random sampling. The general demographic characteristics and parents′ parenting confidence were collected by a self-made questionnaire and KPCS Chinese version. The percentile norm was established. P 3, P10 and P 25 were used as the criteria to define the degree of lack of parenting confidence. Results:The age of mothers was (30.67±4.29). The age of the father was (32.50±4.99) years old. There were 726 (32.76%), 759 (34.25%) and 731 (32.99%) infants in 6-12, 12-23 and 24-35 months old groups. The total scores of P 50, P 25, P 10 and P 3 of KPCS (Chinese version) of infant parents in urban areas in China were 41, 38, 33, and 29 respectively. When the scores of parents were 34-37, 30-33, and ≤ 29, they were judged as mild, moderate, and severe lack of parenting confidence. There was no significant difference in the Chinese version of KPCS between parents of different age groups and parents of different gender (χ2=3.53, P=0.171; χ2=1.41, P=0.236). Each factor score≤ P 3 is defined as the boundary score, and the corresponding boundary scores of "parenting" "support" and "competence" were 13, 9, and 5 respectively. Conclusion:The Chinese version of KPCS can be used to assess the parenting confidence of infants in urban areas of China. It can used as one of the bases for scientific and objective evaluation of the parenting status of families.

How to raise the quality of life of discharged patients with moderate or severe craniocerebral trauma, how to improve their social adaptive ability and reduce occurrence of complications constitute key researches in neurosurgery care. Using two-dimension code plus WeChat friends for continuing care of such patients, the hospital has significantly improved the functional state, activity of daily living, complications and family care ability, contributing to better outcomes of such patients care.

Objective: To characterize the relations between the practice of parenting and associated factors on children (0-5 years old) in urban areas of China, in order to provide evidence for promoting the early development of children and to provide positive guidance and service programs on parenting. Methods: A total of 4 515 parents from 15 cities (14 provinces) were surveyed with a self-administered questionnaire. Parenting and Family Adjustment Scales (PAFAS) was used, including parameters as: consistency and coercive parenting, positive encouragement, parent-child relationship and parental emotion adjustment, family relationship and parental teamwork aspects, etc. Both single factor analysis and multiple linear regression were used to examine the associations between parenting practice, individual, parental and family factors. Results: The mean score of PAFAS was 21.00 (15.00-28.00), associated with factors as children’s age, only-child family, premature delivery, father’s education level, confidence on parenting, problems regarding the parental mood, annual family income, family structure and behavior on seeking professional help, etc. Results showed that there were big differences on the practice of parenting in China and influenced by variety of factors. Conclusions The general situation of parenting was well, in the urban areas of China. The practice of parenting was associated with a series of individual, parental and family factors. Programs on improving the parenting skills and promoting the early development of children, should be highlighted.

Objective? To understand the status quo of professional autonomy, sense of organizational support and professional benefit of stroke specialist nurses, and to analyze the relationship between them. Methods? Using the convenient sampling method, from January to July 2018, a total of 91 stroke specialist nurses from six Class Ⅲ Grade A hospitals in Hangzhou and Wenzhou were selected for the study. The General Data Questionnaire, Professional Autonomy Scale, Organizational Support Scale, and Questionnaire of Nurse' Perceived Professional Benefits were used to collect information about them. Data analysis was performed using independent sample t-test and one-way ANOVA, Pearson correlation analysis, and structural equation model. A total of 91 questionnaires were distributed in this study, and 86 valid questionnaires were used. The effective recovery rate of the questionnaire was 94.51%. Results? A total of 86 stroke specialist nurses got a total average score of (4.47±0.49) in Professional Autonomy Scale, an total average score of (3.02±0.36) in Organizational Support Scale, a total score of (115.56±20.46) in Questionnaire of Nurse' Perceived Professional Benefits;There were statistical differences between stoke specialist nurses with difference genders and titles in terms of their professional benefits(P＜ 0.05). Professional autonomy of stroke specialist nurses plays a mediating role in organizational support and professional benefit, with mediating effect accounting for 32.5% of the total effect. Conclusions? Professional autonomy, job involvement and organizational support affect professional benefit of stroke specialist nurses. Professional autonomy plays a mediating role in organizational support and professional benefit.

Objective To study the application of the family centered escort system in neurosurgical intensive care units (NICU). Methods 416 cases of NICU patients from January 2015 to December 2016 were selected, 197 cases of the patients from January to December 2015 serving as the control group subject to a restrictive visit system. 219 cases of patients from January to December 2016 were used as the study group subject to the family centered escort system. The two groups were compared as to the anxiety state and satisfaction of the family members, the job satisfaction of nurses, the duration and cost of the patients in NICU, the ratio of the patients subject to sedation and restraint bands, and the incidences of adverse events of patients during NICU. Results Scores of anxiety state of the family members showed that the control group (52. 76 ± 5. 21) was significantly higher than that of the study group (34. 61 ± 5. 98). The dimensions of " information acquisition" and " access to patients" as found in the satisfaction survey of the family members showed the study group as higher than the control group, a difference of statistical significance between two groups (both P＜0. 01). The dimensions of " state at work" and " interpersonal relationship at work" showed the study group as higher than the control group, a difference of statistical significance between two groups ( P ＜ 0. 05 ) as found in the job satisfaction survey of nurses. The comparison between the two groups in NICU duration and expenses showed no significant statistical difference (P＞0. 05). The ratio of sedation treatment and restraint band usage of control group was significantly higher than that of the study group, a difference of statistical significance (P＜0. 01). The incidence ratio of lower extremity venous thrombosis showed that the control group (13. 7%, 27/197) was higher than that of the study group (6. 8%, 15/219), a difference of statistical significance (P ＜0. 01). There was no significant difference as to the incidences of other adverse events of the two groups ( P ＞ 0. 05 ). Conclusions Compared with the restricted visiting system, the family centered escort system in NICU is beneficial to both the nurses and patients, justifying the humanity of the latter system.

Objective To explore the threshold of 4 m-walking speed for predicting falls in patients with stroke and to evaluate its clinical significance. Methods A total of 1 079 cases of stroke patients in Neurology Surgery Department and Neurology Medicine Department of the Second Affiliated Hospital of Wenzhou Medical University from July 2015 to May 2017 were selected as the research subjects by convenience sampling method. Data of physical examination, body composition measurement, blood biochemistry, muscle strength and 4 m-walking speed were collected by questionnaire. According to the results of 4 m-walking speed test, the receiver operating characteristic curve (ROC) of subjects was drawn to determine the critical value of 4 m-walking speed for stroke patients, and the predictive value of the critical value of 4 m-walking speed for the risk of falling was analyzed by logistic regression. Results The incidence of falls was 37.5% in stroke patients. The 4 m-walking speed for male and female with stroke was (0.75±0.02) m/s and (0.82±0.06) m/s respectively. ROC curve showed that, in male patients, the critical value of 4 m-walking speed was 0.84 m/s, the area under curve (AUC) was 0.71 (0.65, 0.75), the sensitivity was 87.5%, and the specificity was 65.9%. In female, the critical value of 4 m-walking speed was 0.79 m/s, the AUC was 0.68 (0.62, 0.73), the sensitivity was 75.3%, and the specificity was 78.6%. Logistic regression analysis showed that after adjusting for age, BMI, smoking, alcohol consumption, exercise and disease history, compared with the elderly population below 4 m-walking speed threshold, the OR values of falls in male and female stroke patients above the 4 m-walking speed threshold were 2.97 (1.94, 4.56) and 2.25 (1.40, 3.60) respectively. Conclusions The incidence of fall is high in stroke patients. The threshold of 4 m-walking speed to predict the fall risk of male and female patients with stroke was 0.84 m/s and 0.79 m/s respectively. The determination of the threshold of 4 m-walking speed can provide reference for the prevention of falls in stroke patients and is worthy of clinical popularization and application.

Objective To explore the effect of Mucopolysaccharide Polysulfate Cream by sound conductance for prevention and cure of hand-foot syndrome (HFS) caused by oral chemotherapy in tumor patients and nursing interventions.Methods A total of 76 patients with colorectal cancer (stageⅡ/Ⅲ) in the authors′ hospital who were taking capecitabine in accordance with the requirements of NCCN guideline were selected as subjects from 1 April 2016 to 8 Octobor 2016. The medical records were coded in selected sequential order with the method of randomised controlled clinical trial. All patients (n=76) were randomly divided into control group (n=38, routine nursing care) and observation group (n=38, routine nursing care + intervention imported by Mucopolysaccharide Polysulfate Cream combined with conductivity apparatus) by random number table. The control effect of HFS caused by capecitabine was compared.Results There were 9 patients (23.7%) with HFS after intervention including 6 cases forⅠ, 3 cases forⅡ, 0 forⅢ. There were 17 patients (44.7%) with HFS after intervention including 9 cases forⅠ,7 cases forⅡ, 1 forⅢ. There was a statistically significant difference in HFS between two groups (Z=2.029,P<0.05). The result of symptom quantized integration of HFS (erythema, edema, dryness, desquamation and so on) of 9 patients with HFS in observation group was obviously better than that of 17 patients with HFS in control group with a significant difference (P<0.05). The score of KPS of 9 patients with HFS in observation group was (88.68±6.80) obviously better than that (82.99±9.51) of 17 patients with HFS in control group with a significant difference (t=2.892,P<0.05).Conclusions The prevention and cure intervention imported by Mucopolysaccharide Polysulfate Cream combined with conductivity apparatus along with nursing intervention can obviously lessen the symptoms of HFS of patients with oral chemotherapy and improve the chemotherapy tolerance.