Objective To investigate the current status of cardiovascular nurses in intake and output recording of heart failure patients,and to provide a basis for further standardizing these practices.Methods A convenience sampling method was used to survey 7,761 cardiovascular nurses from 31 provinces in China in May 2024 using a self-designed questionnaire.The survey content included the content and methods of recording fluid intake and output,methods of liquid measurement,health education for patients and caregivers,and verification of the accuracy of fluid intake and output records.The chi-square test was used for comparison between groups.Results A total of 7,726 valid questionnaires were collected,with an effective response rate of 99.55％.Solid food(85.00％)and insensible water loss such as sweat(59.63％)were the lowest proportion items in the recording of intake and output,respectively.A total of 6,343 nurses(82.10％)reported that their wards had standardized"intake and output record forms".A total of 3,782 nurses(48.95％)were able to use graduated measuring cups to quantify water intake,and 3,587 nurses(46.43％)could use a"food water content table"to convert the water content of solid foods.Additionally,5,050 nurses(65.36％)involved patients and caregivers in the recording of intake and output,and 5,419 nurses(70.14％)provided health education on intake and output recording to patients and caregivers.Furthermore,4,753 nurses(61.52％)verified the accuracy of the 24-hour intake and output records after completion.Nurses whose wards regularly provided training on intake and output recording,as well as those whose wards included the accuracy of intake and output recording in quality control,demonstrated better practice outcomes in this regard(P＜0.001).Conclusion The current clinical nursing practice of cardiovascular nurses in recording the intake and output of heart failure patients needs improvement.Relevant academic organizations should further refine the standards related to intake and output recording.Medical institutions should focus on strengthening training and quality control,optimizing clinical operation procedures,and providing material,institutional,and human resource support to improve the accuracy of fluid intake and output recording for heart failure patients and ensure patient safety.

Objective To investigate the current status of cardiovascular nurses in intake and output recording of heart failure patients,and to provide a basis for further standardizing these practices.Methods A convenience sampling method was used to survey 7,761 cardiovascular nurses from 31 provinces in China in May 2024 using a self-designed questionnaire.The survey content included the content and methods of recording fluid intake and output,methods of liquid measurement,health education for patients and caregivers,and verification of the accuracy of fluid intake and output records.The chi-square test was used for comparison between groups.Results A total of 7,726 valid questionnaires were collected,with an effective response rate of 99.55％.Solid food(85.00％)and insensible water loss such as sweat(59.63％)were the lowest proportion items in the recording of intake and output,respectively.A total of 6,343 nurses(82.10％)reported that their wards had standardized"intake and output record forms".A total of 3,782 nurses(48.95％)were able to use graduated measuring cups to quantify water intake,and 3,587 nurses(46.43％)could use a"food water content table"to convert the water content of solid foods.Additionally,5,050 nurses(65.36％)involved patients and caregivers in the recording of intake and output,and 5,419 nurses(70.14％)provided health education on intake and output recording to patients and caregivers.Furthermore,4,753 nurses(61.52％)verified the accuracy of the 24-hour intake and output records after completion.Nurses whose wards regularly provided training on intake and output recording,as well as those whose wards included the accuracy of intake and output recording in quality control,demonstrated better practice outcomes in this regard(P＜0.001).Conclusion The current clinical nursing practice of cardiovascular nurses in recording the intake and output of heart failure patients needs improvement.Relevant academic organizations should further refine the standards related to intake and output recording.Medical institutions should focus on strengthening training and quality control,optimizing clinical operation procedures,and providing material,institutional,and human resource support to improve the accuracy of fluid intake and output recording for heart failure patients and ensure patient safety.

In recent years, with the in-depth study of pemphigus, new pathogenesis has been identified based on the desmoglein antibody-mediated immune response mechanism, and new progress has been made in targeted therapy. This review summarizes recent advances in the pathogenesis and targeted therapy of pemphigus.

Objective:To investigate the clinical characteristics and perinatal outcomes of preeclampsia (PE) with severe fetal growth restriction (FGR) as the initial symptom.Methods:This retrospective cohort study included cases of singleton live births with PE and severe FGR delivered at Fujian Maternity and Child Health Hospital from January 2012 to December 2022. The cases were divided into two groups based on the sequence of severe FGR and hypertension onset: the severe FGR-first group and the hypertension-first group. General data, clinical characteristics, pregnancy complications, and neonatal outcomes were analyzed between the two groups. Statistical analyses were performed using t-tests, Mann-Whitney U tests, and Chi-square tests. Multivariate linear regression or logistic regression analyses were used to adjust for the effects of confounding factors on perinatal outcomes. Results:(1) A total of 307 cases were included in the study, with 194 cases (63.2%) in the severe FGR-first group and 113 cases (36.8%) in the hypertension-first group. Compared to the hypertension-first group, the severe FGR-first group had a higher proportion of severe FGR before 32 weeks, later gestational age at PE diagnosis, lower proportion of early-onset PE, greater gestational age at pregnancy termination, and shorter interval from PE diagnosis to pregnancy termination [40.7% (46/113) vs. 59.3% (115/194), χ2=9.87; (32.8±5.1) weeks vs. (35.6±3.4) weeks, t=5.12; 52.2% (59/113) vs. 25.8% (50/194), χ2=21.80; (34.7±3.1) weeks vs. (36.0±3.2) weeks, t=3.43; all P<0.01]. There was no statistically significant difference in the interval between the diagnosis of severe FGR and hypertension between the two groups. (2) Compared to the hypertension-first group, the severe FGR-first group had a lower preterm birth rate and a higher incidence of premature rupture of membranes [69.0% (78/113) vs. 46.9% (91/194), χ2=14.12; 9.7% (11/113) vs. 19.1% (37/194), χ2=4.72; both P<0.05]. After adjusting for differences in gestational age at termination of pregnancy using multivariate logistic regression analysis, the results showed no statistically significant differences in the incidence of pregnancy complications between the two groups. (3) Compared with the hypertension-first group, the severe FGR-first group had higher neonatal birth weight [(1 757±605) g vs. (2 067±684) g, t=4.12], longer birth length [(41.7±4.3) cm vs. (43.4±4.6) cm, t=3.10], and heavier placentas [(399±158) g v s. (486±147) g, t=2.36]. The rates of cesarean section, severe small for gestational age, and low birth weight were lower [85.8% (97/113) vs. 68.6% (133/194), χ2=11.35; 65.5% (74/113) vs. 49.5% (96/194), χ2=7.40; 87.6% (99/113) vs. 69.6% (135/194), χ2=12.80; all P<0.05]. There were no statistically significant differences in the 1-minute Apgar scores and NICU admission rates between the two groups. After adjusting for differences in gestational age at termination of pregnancy using multivariate regression analysis, it was found that compared with the hypertension-first group, the severe FGR-first group had heavier neonates and a lower risk of cesarean section [ OR (95% CI) were 80.18 (0.95-159.42) and 0.51 (0.26-0.99), both P<0.05]. Conclusions:Pregnant women with severe FGR preceding PE have a later onset of PE and relatively better perinatal outcomes compared to those with hypertension preceding PE. It is necessary to strengthen the monitoring of blood pressure fluctuations in pregnant women with severe FGR preceding PE and fetal growth in pregnant women with hypertension preceding PE.

Objective:To explore the talent cultivation model of nursing professional group under the 1+X certificate system, to build a talent cultivation system for nursing professional groups with "three progressions, four integrations, and five cocultivation"Methods:From 1 July 2021 to 31 December 2023, built a professional group course system of "mutual sharing of foundations, mutual generation of majors, mutual selection of positions, and progressive improvement of abilities". Aligned course content with X certificate content. Deepen the reform of the three education systems, create a "dual teacher" teaching team that combines full-time and part-time work, and build teaching resources that connect the cloud and the ground. The application effect of this model was evaluated in 2021 nursing majors in Cangzhou Medical College by cluster sampling.Results:There were 748 students majoring in nursing in class of 2021, 150 boys aged 19-22(20.00 ± 1.23), 598 girls, aged 19-21(19.00 ± 2.57). There were 118 students majoring in midwifery in class of 2021, all of them were girls, aged 18-20(18.00 ± 2.11). There were 128 students majoring in rehabilitation therapy technology in class of 2021, 66 boys aged 19-21(19.00 ± 2.11), 62 girls aged 19-21(19.00 ± 2.54). Nursing professional group completed the "Basic Nursing Technology Training Guidance", "Elderly Care" and other 5 self-compiled textbooks, 730 students had participated in the X certificate assessment, 729 students e passed the assessment, the passing rate was 99.9%.Conclusions:The talent cultivation model of "three progressions, four integrations, and five co cultivation" in the nursing professional group can cultivate students′ professional abilities, and cultivate a composite technical and skilled talent with multiple abilities and interconnections in one job.

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.

BACKGROUND: The effect of intra-operative chemotherapy (IOC) on the long-term survival of patients with colorectal cancer (CRC) remains unclear. In this study, we evaluated the independent effect of intra-operative infusion of 5-fluorouracil in combination with calcium folinate on the survival of CRC patients following radical resection. METHODS: 1820 patients were recruited, and 1263 received IOC and 557 did not. Clinical and demographic data were collected, including overall survival (OS), clinicopathological features, and treatment strategies. Risk factors for IOC-related deaths were identified using multivariate Cox proportional hazards models. A regression model was developed to analyze the independent effects of IOC. RESULTS: Proportional hazard regression analysis showed that IOC (hazard ratio [HR]=0.53, 95% confidence intervals [CI] [0.43, 0.65], P  < 0.001) was a protective factor for the survival of patients. The mean overall survival time in IOC group was 82.50 (95% CI [80.52, 84.49]) months, and 71.21 (95% CI [67.92, 74.50]) months in non-IOC group. The OS in IOC-treated patients were significantly higher than non-IOC-treated patients ( P  < 0.001, log-rank test). Further analysis revealed that IOC decreased the risk of death in patients with CRC in a non-adjusted model (HR=0.53, 95% CI [0.43, 0.65], P  < 0.001), model 2 (adjusted for age and gender, HR=0.52, 95% CI [0.43, 0.64], P  < 0.001), and model 3 (adjusted for all factors, 95% CI 0.71 [0.55, 0.90], P  = 0.006). The subgroup analysis showed that the HR for the effect of IOC on survival was lower in patients with stage II (HR = 0.46, 95% CI [0.31, 0.67]) or III disease (HR=0.59, 95% CI [0.45, 0.76]), regardless of pre-operative radiotherapy (HR=0.55, 95% CI [0.45, 0.68]) or pre-operative chemotherapy (HR=0.54, 95% CI [0.44, 0.66]). CONCLUSIONS: IOC is an independent factor that influences the survival of CRC patients. It improved the OS of patients with stages II and III CRC after radical surgery. TRIAL REGISTRATION chictr.org.cn, ChiCTR 2100043775.
Humans ; Fluorouracil/therapeutic use* ; Leucovorin/therapeutic use* ; Colorectal Neoplasms/pathology* ; Retrospective Studies ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Proportional Hazards Models ; Prognosis

Objective:To analyze the clinical characteristics of patients with acute glyphosate herbicide poisoning and the differences in the severity of poisoning.Methods:A retrospective analysis was performed on patients with acute glyphosate herbicide poisoning admitted to the First Affiliated Hospital of Zhengzhou University from January 2014 to December 2020. The general information, exposure time, poisoning dose, poisoning cause, poisoning route, clinical manifestations, laboratory examination results during hospitalization, treatment measures, hospital stays and prognosis of the patients were collected. The patients were graded according to the poisoning severity scoring standard of Chinese Expert Consensus on Diagnosis and Treatment of Acute Poisoning in 2016. The highest severity score during hospitalization was used as the final grade. According to the final grade, asymptomatic and mild patients were included in the mild group, and moderate, severe and death patients were included in the severe group. The independent sample T test or Mann-Whitney U test was used for measurement data, and χ2 test or Fisher's exact test was used for counting data. The differences of general data and clinical data between the two groups were compared. Results:According to the inclusion and exclusion criteria, 83 patients with acute glyphosate herbicide poisoning were selected as the study subjects. All patients survived, mainly mild poisoning (56.6%), with a male to female ratio of 33∶50, and an average age of 39 years. The number of poisoning cases increased yearly (the highest in 2019), and most cases occurred in spring and summer. The main cause of poisoning was suicide (71.1%), direct oral administration (83.1%) was the primary route of poisoning, and the dominating clinical manifestations were digestive symptoms (71.1%). Laboratory tests showed increased white blood cell count (WBC), neutrophil percentage (NEUT %) and D-dimer, and decreased hemoglobin and potassium. Compared with the mild group, patients in the severe group were older [(51±17) years vs. (35±19) years], had a higher proportion of suicide and direct oral administration, a longer hospital stay [8.0 (4.8, 12.0) d vs. 3.0 (2.0, 5.5) d], a higher dose of poisoning [200.0 (50.0, 200.0) mL vs. 30.0 (11.3, 57.5) mL], and higher NEUT % within 24 h of admission [(83.4±10.4) vs. (73.2±12.8)]. The increase of WBC, NEUT %, aspartate aminotransferase, prothrombin time, D-dimer and the decrease of serum potassium were more common in the severe group than the mild group, with statistical significance (all P<0.05). Conclusions:The number of patients with acute glyphosate herbicide poisoning is increasing yearly. Generally, the condition is mild and the prognosis is satisfying. The severity is more serious in the middle-aged and elderly patients andthose with direct oral administration, high toxic dose, and high NEUT % within 24 h of admission. Severe poisoning is more likely to cause changes in laboratory indicators.

Objective:To observe the clinical effect of Yiqi Yangjing recipe combined with sticking therapy on lung cancer pleural effusion.Methods:From December 2017 to August 2019, 68 patients with advanced lung cancer and pleural effusion in Pudong New Area Hospital of Traditional Chinese Medicine were selected and randomly divided into two groups by random number table method, with 34 cases in each group.The control group was given furosemide orally on the basis of routine nutritional support treatment, and the treatment group was given Yiqi Yangjing prescription orally and traditional Chinese medicine sticking therapy on the basis of the control group.Both two groups were treated for 6 weeks.The changes of pleural fluid volume and quality of life scores were observed and compared between the two groups.Results:The total effective rate in the treatment group was 70.5%(24/34), which in the control group was 47.1%(16/34), the difference was statistically significant between the two groups(χ 2=3.886, P<0.05). The total effective rate of TCM syndrome integral was 64.7%(22/34) in the treatment group, and 35.3%(12/34) in the control group, the difference was statistically significant between the two groups(χ 2=5.800, P<0.05). After treatment, the overall quality of life score of the treatment group(55.74±5.15)points, which was higher than that of the control group[(51.91±5.20)points]( t=56.130, P<0.05). Conclusion:Yiqi Yangjing recipe combined with traditional Chinese medicine sticking therapy can effectively improve the clinical efficacy of lung cancer hydrothorax, improve the quality of life of patients.