Objective: To investigate the causes and characteristics of immune hemolytic transfusion reactions (HTRs) triggered by anti-E antibodies, so as to provide a scientific reference for guaranteeing clinical blood transfusion safety. Methods: Five patients who experienced HTRs in our hospital from November 2023 to October 2024 were selected as the research subjects. ABO/RhD blood grouping, antibody screening, antibody identification, and the direct antiglobulin test (DAT) were conducted using the column agglutination method. The causes of HTRs in these patients were investigated using multiple techniques such as the two-step enzyme method, polyethylene glycol (PEG), acid elution technique, and capillary centrifugation method. Results: All five patients tested negative for antibody screening prior to transfusion. However, after transfusion of E+ phenotyped blood, patients 1, 2, 3, and 5 developed delayed haemolytic transfusion reaction (DHTR), while patient 4 experienced acute haemolytic transfusion reaction (AHTR). Anti-E antibodies were detected in all blood samples from the patients after the hemolytic transfusion reaction, including the enzyme-only anti-E antibody in two cases. Conclusion: Anti-E antibody can trigger both intravascular and extravascular hemolysis. It is recommended to conduct ABO/RhD and RhE antigen-matched transfusions and establish a regional blood transfusion database to reduce immune hemolytic transfusion reactions caused by anti-E antibody.

Objective This study develops and evaluates a just-in-time adaptive intervention(JITAI)-based smart nursing protocol for interventional radiology preoperative waiting areas,assessing its impact on patient experience Methods A time-series design was employed.Patients in the waiting area of an interventional operating room at a tertiary hospital in Chengdu,Sichuan Province,were studied during April and August 2024.Participants were divided into an intervention group(n=766)and a control group(n=864).The intervention group received the newly developed management protocol,while the control group received conventional nursing care.Differences between the groups were compared regarding perceived waiting time,actual waiting time,preoperative anxiety levels,and satisfaction rates.Results Totally 13 participants were lost to follow-up in the intervention group and 11 in the control group,resulting in final analyzed cohorts of 753 and 853 patients,respectively.The median actual waiting time was significantly shorter in the intervention group with 50.03(23.92,76.38)min,compared to the control group with 65.62(35.77,104.32)min.A significant difference was observed between the 2 groups(P＜0.001).Similarly,the median perceived waiting time was significantly lower in the intervention group with 48.00(20.00,70.00)min than 73.00(38.00,105.00)min in the control group.A significant difference was observed between the 2 groups(P＜0.001).The anxiety score during the waiting period was lower in the experimental group than it in the control group,and the experimental group showed a significantly higher satisfaction level compared to the control group,with both dif ferences being statistically significant(P＜0.05).Conclusion The intelligent nursing program,developed based on the JIT AI theory,effectively reduces both the actual and perceived preoperative waiting time for patients in the in-terventional operating room,optimizing their preoperative waiting experience.

Objective To systematically evaluate and analyze qualitative studies of parental engagement in kangaroo mother care experiences for preterm infants in the NICU,aiming to provide references for promoting the early recovery of preterm infants in NICU and improving the quality of nursing services.Methods Relevant were searched for qualitative studies of parental engagement in kangaroo mother care for preterm infants in NICU.The search time limit was from the construction of the database to July 19,2024.The quality of the included literature was assessed using the Joanna Brigg Institute's(JBI)Australian Centre for Evidence-Based Health Care's Quality Assessment Criteria for Qualitative Research,and the results were integrated using the meta-integration methods.Results A total of 17 papers were included in the literature,and 61 findings were extracted,grouped into 10 new categories.These were further synthesized into 4 integrated findings:physical and psychological perceptions of participation in kangaroo mother care;challenges to participation in kangaroo mother care;facilitators of participation in kangaroo mother care;expectations and suggestions for kangaroo mother care.Conclusion Hospital administrators should further improve the management specifications of kangaroo mother care for preterm infants in NICU,optimize resource allocation and strengthen publicity.At the same time,healthcare professionals should actively promote the establishment of peer and family support systems and increase participation in kangaroo mother care to facilitate early recovery of preterm infants in NICU and to continuously promote the improvement of nursing service quality.

Objective Under the"Key Information Infrastructure Security Protection Requirements for Information Secu-rity Technology"(hereinafter referred to as"Security Protection Requirements"),this study aims to construct a security protec-tion system for medical information systems and improve their security protection capabilities.Methods Starting from the char-acteristics and security requirements of medical information systems,combined with the standard"Security Protection Require-ments",this study discusses and analyzes the construction of six aspects of security protection capabilities:identification,securi-ty protection,detection and evaluation,monitoring and warning,active defense,and event handling,and implements protection for key information infrastructure in medical institutions from both software and hardware aspects.Results A practical,system-atic,and normalized security protection system for medical information systems has been constructed to achieve comprehensive protection of medical information systems.Conclusion Under the requirements of"Security Protection Requirements",it is crucial to establish a comprehensive security protection system for medical information systems and implement the protection of key information infrastructure in medical institutions from both software and hardware aspects.This provides a scientific basis and practical guidance for network security protection in the medical industry.

Objective Under the"Key Information Infrastructure Security Protection Requirements for Information Secu-rity Technology"(hereinafter referred to as"Security Protection Requirements"),this study aims to construct a security protec-tion system for medical information systems and improve their security protection capabilities.Methods Starting from the char-acteristics and security requirements of medical information systems,combined with the standard"Security Protection Require-ments",this study discusses and analyzes the construction of six aspects of security protection capabilities:identification,securi-ty protection,detection and evaluation,monitoring and warning,active defense,and event handling,and implements protection for key information infrastructure in medical institutions from both software and hardware aspects.Results A practical,system-atic,and normalized security protection system for medical information systems has been constructed to achieve comprehensive protection of medical information systems.Conclusion Under the requirements of"Security Protection Requirements",it is crucial to establish a comprehensive security protection system for medical information systems and implement the protection of key information infrastructure in medical institutions from both software and hardware aspects.This provides a scientific basis and practical guidance for network security protection in the medical industry.

Objective This study develops and evaluates a just-in-time adaptive intervention(JITAI)-based smart nursing protocol for interventional radiology preoperative waiting areas,assessing its impact on patient experience Methods A time-series design was employed.Patients in the waiting area of an interventional operating room at a tertiary hospital in Chengdu,Sichuan Province,were studied during April and August 2024.Participants were divided into an intervention group(n=766)and a control group(n=864).The intervention group received the newly developed management protocol,while the control group received conventional nursing care.Differences between the groups were compared regarding perceived waiting time,actual waiting time,preoperative anxiety levels,and satisfaction rates.Results Totally 13 participants were lost to follow-up in the intervention group and 11 in the control group,resulting in final analyzed cohorts of 753 and 853 patients,respectively.The median actual waiting time was significantly shorter in the intervention group with 50.03(23.92,76.38)min,compared to the control group with 65.62(35.77,104.32)min.A significant difference was observed between the 2 groups(P＜0.001).Similarly,the median perceived waiting time was significantly lower in the intervention group with 48.00(20.00,70.00)min than 73.00(38.00,105.00)min in the control group.A significant difference was observed between the 2 groups(P＜0.001).The anxiety score during the waiting period was lower in the experimental group than it in the control group,and the experimental group showed a significantly higher satisfaction level compared to the control group,with both dif ferences being statistically significant(P＜0.05).Conclusion The intelligent nursing program,developed based on the JIT AI theory,effectively reduces both the actual and perceived preoperative waiting time for patients in the in-terventional operating room,optimizing their preoperative waiting experience.

Objective To systematically evaluate and analyze qualitative studies of parental engagement in kangaroo mother care experiences for preterm infants in the NICU,aiming to provide references for promoting the early recovery of preterm infants in NICU and improving the quality of nursing services.Methods Relevant were searched for qualitative studies of parental engagement in kangaroo mother care for preterm infants in NICU.The search time limit was from the construction of the database to July 19,2024.The quality of the included literature was assessed using the Joanna Brigg Institute's(JBI)Australian Centre for Evidence-Based Health Care's Quality Assessment Criteria for Qualitative Research,and the results were integrated using the meta-integration methods.Results A total of 17 papers were included in the literature,and 61 findings were extracted,grouped into 10 new categories.These were further synthesized into 4 integrated findings:physical and psychological perceptions of participation in kangaroo mother care;challenges to participation in kangaroo mother care;facilitators of participation in kangaroo mother care;expectations and suggestions for kangaroo mother care.Conclusion Hospital administrators should further improve the management specifications of kangaroo mother care for preterm infants in NICU,optimize resource allocation and strengthen publicity.At the same time,healthcare professionals should actively promote the establishment of peer and family support systems and increase participation in kangaroo mother care to facilitate early recovery of preterm infants in NICU and to continuously promote the improvement of nursing service quality.

Objective To analyze the risk factors of malnutrition in multidrug resistant tuberculosis(MDR-TB)patients.Methods A total of 96 MDR-TB patients admitted to Jiangxi Chest Hospital from September 2021 to March 2023 were selected as study objects.The malnutrition status of patients was evaluated by using mini-nutritional assessment short-form,and the basic data of patients were investigated.Logistic regression analysis was used to investigate the risk factors of malnutrition in MDR-TB patients.Results Of 96 MDR-TB patients,51 cases(53.12%)were malnourished.Logistic regression analysis results showed that age≥60 years old,chronic diseases,insomnia,anxiety and depression,and family dysfunction were all risk factors for malnutrition in MDR-TB patients(P<0.05).Conclusion MDR-TB patients have a high risk of malnutrition,which is affected by age,chronic diseases,sleep status,psychological status,and family function.Nursing programs can be formulated according to the above factors,such as sleep guidance,psychological support,and family intervention,in order to reduce the risk of malnutrition in patients.

Objective To analyze the current situation of healthcare-associated infection (HCAI) management of fever clinics among different levels of medical institutions in Wuhan, and to provide a scientific basis for improving hospital infection management. Methods In January 2023, a network questionnaire survey was conducted on medical institutions with fever clinics in Wuhan. Results A total of 72 medical institutions were investigated, of which 58.33% had CT, and 48.61% had fever clinics for children. The total qualified rate of HCAI management was 78.28%. The qualified rates of four primary indicators, including hospital management, diagnosis and treatment environment protection, training and education, and implementation of infection control measures, were 82.27%, 71.49%, 75.93%, and 81.31%, respectively. There were statistical differences among different levels of medical institutions (all P<0.01). Among the 13 secondary indicators, the qualified rates of 7 indicators were more than 80%, with the highest being medical item management (93.06%), medical waste disposal (89.72%), and personnel management (83.33%), and the lowest being facilities and equipment (66.32%), and patients and accompanying personnel education (66.67%). Among the 65 tertiary indicators, 30 had a pass rate great than 80%. Conclusion Wuhan actively promotes the construction of fever clinics in medical institutions, and the overall situation of HCAI management is good. However, there are still some problems to varying degrees, especially in the layout procedures, hand hygiene, and staff training of fever clinics in secondary and lower medical institutions, which should be further strengthened.

To sum up integrative nursing experience of a case with chronic refractory wound formation caused by drug extravasation.The essentials of integrative nursing are:structured nursing intervention of"assessment-management-treatment"based on the Triangle of Wound Assessment;determination of the timing for integrative nursing according to the theory of TCM sores and ulcers;implementation of copper board scraping method to promote circulation of qi and blood;use of Huo-long Comprehensive Moxibustion Therapy to promote muscle regeneration.With the help of the cooperation of the multidisciplinary specialist nursing team,the wound was completely healed after 59 days of integrated traditional Chinese and Western medicine nursing interventions.