Objective To explore the internal correlation mechanism among symptoms and influencing factors in first-ever subacute stroke patients.Methods A cross-sectional survey method was employed to conveniently select stroke patients hospitalized in a tertiary hospital in Guangdong Province from October 2022 to June 2023.Data were collected using a general information questionnaire,Symptom Experience Scale for Stroke Survivors,Fear of Progression Questionnaire-Short Form,Acceptance of Illness Scale,Herth Hope Index,and the Memorial University of Newfoundland Scale of Happiness.Results A total of 316 stroke patients were included.The incidence of symptom burden ranged from 17.41％to 87.97％,with the core,bridge,and sentinel symptoms as decreased attention and restricted limb movements,restricted limb movements and decreased self-care ability,and limb weakness and delayed response,respectively.Age,stroke type,disease stage,self-care ability,fear of disease progression,hope level,and happiness level were predictive factors for symptom burden in patients.Mixed network analysis showed direct correlation between foot inversion and stroke type,fear of disease progression was directly associated with limb weakness and limb pain.Low mood was directly correlated with hope level and happiness level.Conclusion Symptoms in patients with first-episode subacute stroke are interrelated.Nurses should pay attention to the identification of core,bridge,and sentinel symptoms,understand the associations between symptoms and influencing factors,and provide comprehensive and personalized clinical symptom management strategies for patients.

Objective To explore the internal correlation mechanism among symptoms and influencing factors in first-ever subacute stroke patients.Methods A cross-sectional survey method was employed to conveniently select stroke patients hospitalized in a tertiary hospital in Guangdong Province from October 2022 to June 2023.Data were collected using a general information questionnaire,Symptom Experience Scale for Stroke Survivors,Fear of Progression Questionnaire-Short Form,Acceptance of Illness Scale,Herth Hope Index,and the Memorial University of Newfoundland Scale of Happiness.Results A total of 316 stroke patients were included.The incidence of symptom burden ranged from 17.41％to 87.97％,with the core,bridge,and sentinel symptoms as decreased attention and restricted limb movements,restricted limb movements and decreased self-care ability,and limb weakness and delayed response,respectively.Age,stroke type,disease stage,self-care ability,fear of disease progression,hope level,and happiness level were predictive factors for symptom burden in patients.Mixed network analysis showed direct correlation between foot inversion and stroke type,fear of disease progression was directly associated with limb weakness and limb pain.Low mood was directly correlated with hope level and happiness level.Conclusion Symptoms in patients with first-episode subacute stroke are interrelated.Nurses should pay attention to the identification of core,bridge,and sentinel symptoms,understand the associations between symptoms and influencing factors,and provide comprehensive and personalized clinical symptom management strategies for patients.

Objective:To investigate the effects of ultrasound-guided serratus plane block (US-SPB) on stress response, serum cancer antigen 153 (CA153) and neuron-specific enolase (NSE) levels in patients undergoing radical mastectomy.Methods:A total of 110 patients with radical mastectomy who were admitted to our hospital from Feb. 2022 to Feb. 2024 were chosen and separated into US-SPB group ( n=55, US-SPB) and control group ( n=55, conventional anesthesia) by the principle of random number table. The differences of stress index, tumor index, pain, sedation, and operation related index were observed between the two groups. Results:24h after operation, serum cortisol (Cor), epinephrine (EPI) and noradrenaline (NE) in US-SPB group were significantly lower than those in control group ( t=4.69, 5.07, 5.38, P<0.05) ; The levels of serum CA153 and NSE in US-SPB group were significantly lower ( t=2.15, 2.04, P<0.05) ; The visual analogue scales (VAS) scores and Ramsay sedation score (RSS) scores in US-SPB group were significantly lower at 6h, 12h and 24h after surgery (VAS: Finter-group =17.67, Pinter-group <0.05; Ftime =15.58, Ptime <0.05; Finteraction =0.96, Pinteraction > 0.05; RSS: Finter-group =12.77, Pinter-group <0.05; Ftime =10.88, Ptime <0.05; Finteraction =0.32, Pinteraction > 0.05) ; The intraoperative dosage of remifentanil and the postoperative dosage of sufentanil in US-SPB group were significantly lower ( t=1.99, P<0.05) . Conclusion:US-SPB can not only reduce the stress response of patients undergoing radical mastectomy, but also have a positive effect on the reduction of tumor marker levels, and the pain management effect is better.

BACKGROUND: Posterior lumbar non-fusion devices have been developed to control vertebral column movement, change load pattern of instability segment, restrict abnormal action, as well as avoid adjacent segment degeneration.OBJECTIVE: To investigate the efficiency of Wallis dynamic stabilization system in the treatment of lumbar vertebrae instability.METHODS: Ten cases suffering from lumbar instability were selected, including 3 males and 7 females, aged 43-65 years. One patient sustained L_(1/2) and L_(4/5) segmental instability, one was L_(2/3) and another was L_(3/4), and the others were L_(4/5). Two patients complicated with lumbar disc herniation and 7 patients combined with lumbar spinal stenosis at the same affected segment, and 3 patients associated with lumbar spinal stenosis at adjacent segment. All unstable segments were treated with decompression, posterior implantation of Wallis dynamic stabilization system. Visual analogue scale (VAS) and Japanese Orthopedic Association (JOA) scores for low back pain and Oswestry disability index (ODI) were used to evaluate clinical outcomes. In addition, therange of motion (ROM) at the instrumented segment and adjacent segments and posterior disc height (PDH) in standing and extension position at L_(4/5) segment were also measured.RESULTS AND CONCLUSION: All the patients were followed-up for 2-13 months, mean 9.2 months. The mean operation duration was 128 minutes (90-185 minutes), with bleeding volume of 264 Ml (50-600 Ml). Sings and symptoms of all patients were improved significantly after operation, except one patient with recurrence of L_(4/5) lumbar spinal stenosis at 3 month after surgery, whose symptoms relieved by revision with fenestration and decompression. The postoperative VAS was dramatically decreased than that of preoperation (P=0.003); the JOA score was obviously increased (P=0.002), and the ODI score was decreased (p=0.008). The postoperative range of motion decreased significantly (P<0.05). However, there was no obviously difference between preoperative and postoperative L_(3/4), L_5/S_1 and posterior disc height (P>0.05). Good clinical results can be achieved by surgical intervention with Wallis dynamic stabilization system in treating lumbar vertebrae instability.