Objective:To explore the current status and latent profiles of home care needs among caregivers of post-stroke dysphagia (PSD) patients, providing evidence for precision nursing interventions.Methods:Caregivers of PSD patients hospitalized at Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine were selected as the study subjects through convenience sampling from December 2022 to December 2023. A cross-sectional survey was conducted through General Information Questionnaire for PSD Patients and Caregivers, Caregiver Competence Questionnaire for Dysphagia Patients, Zarit Caregiver Burden Interview, and Home Care Needs Scale for Primary Caregivers of Stroke Patients. Latent categories of home care needs among PSD patients' caregivers were identified through latent profile analysis. Influencing factors of latent categories were explored based on univariate analysis and multivariable logistic regression.Results:A total of 168 questionnaires were distributed, with 162 valid questionnaires recovered, yielding an effective response rate of 96.42%. Among the 162 patients, 82 were male and 80 were female, with an age of 78(68, 84) years.Among the 162 caregivers, 51 were male and 111 were female, with an age of 60(52, 68) years. The score of home care needs for primary caregivers was (89.89 ± 15.75) points. Based on the level of home care needs, caregivers were divided into four latent categories: skilled type-low demand, balanced type-medium demand, unfamiliar type-high demand, skilled type - high demand, accounting for 32.1%(52/162), 40.1%(65/162), 8.7%(14/162), and 19.1%(31/162), respectively. Whether the patient had pneumonia, caregiver gender, and caregiver education level were found as influencing factors for home care needs through multivariate Logistic regression analysis ( OR values were 0.10 to 13.88, all P<0.05). Conclusions:The home care needs of caregivers for PSD patients are at a moderate-to-high level and exhibit heterogeneity. Clinical nursing staff should implement targeted interventions to promote the recovery of PSD patients based on caregivers' categorical characteristics

Objective:To explore the current status and latent profiles of home care needs among caregivers of post-stroke dysphagia (PSD) patients, providing evidence for precision nursing interventions.Methods:Caregivers of PSD patients hospitalized at Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine were selected as the study subjects through convenience sampling from December 2022 to December 2023. A cross-sectional survey was conducted through General Information Questionnaire for PSD Patients and Caregivers, Caregiver Competence Questionnaire for Dysphagia Patients, Zarit Caregiver Burden Interview, and Home Care Needs Scale for Primary Caregivers of Stroke Patients. Latent categories of home care needs among PSD patients' caregivers were identified through latent profile analysis. Influencing factors of latent categories were explored based on univariate analysis and multivariable logistic regression.Results:A total of 168 questionnaires were distributed, with 162 valid questionnaires recovered, yielding an effective response rate of 96.42%. Among the 162 patients, 82 were male and 80 were female, with an age of 78(68, 84) years.Among the 162 caregivers, 51 were male and 111 were female, with an age of 60(52, 68) years. The score of home care needs for primary caregivers was (89.89 ± 15.75) points. Based on the level of home care needs, caregivers were divided into four latent categories: skilled type-low demand, balanced type-medium demand, unfamiliar type-high demand, skilled type - high demand, accounting for 32.1%(52/162), 40.1%(65/162), 8.7%(14/162), and 19.1%(31/162), respectively. Whether the patient had pneumonia, caregiver gender, and caregiver education level were found as influencing factors for home care needs through multivariate Logistic regression analysis ( OR values were 0.10 to 13.88, all P<0.05). Conclusions:The home care needs of caregivers for PSD patients are at a moderate-to-high level and exhibit heterogeneity. Clinical nursing staff should implement targeted interventions to promote the recovery of PSD patients based on caregivers' categorical characteristics

Objective:To investigate the research trend and scope of prevention of central venous catheter-related bloodstream infection (CRBSI) in burn patients.Methods:The scoping review method was adopted. Pre-retrieval was carried out with search terms of "中心静脉导管, 烧伤, 感染" and "central venous catheter, infection, catheter-related bloodstream infection, burn". On the basis of pre-retrieval, different retrieval formulas were formulated to retrieve researches related to central venous CRBSI in burn patients in China National Knowledge Internet, Wanfang Database, VIP Database, PubMed, Embase, CINAHL, and Cochrane Library from the establishment of each database to August 2020. Data were extracted from the included literature, including the first author, research publication time, research country, research type, diagnosis basis and intervention measures of central venous CRBSI, research sample selection, incidence related to infection, and research conclusion. Results:A total of 20 randomized controlled trials, quasi-experimental studies, case-control studies, cohort studies, and implementation researches published in 1990-2020 were included in this study with the first authors from China, the United States of America, or Argentina. The diagnostic bases for central venous CRBSI in burn patients were not uniform in the included literature, including adopting the Guidelines of American Centers for Disease Control and Prevention, Diagnostic Criteria for Nosocomial Infection, and other diagnostic criteria without specifying the source. The intervention measures included the use of new materials such as antibiotics coated catheter and ethanol impregnated port protectors, multidisciplinary cooperation, and comprehensive preventive measures. The sample size in the included literature was small, and the sample selection was different, including the number of patients and the the number of placement of central venous catheter. The outcome indicators for infection in the included literature were diversified. The incidence per 1 000 days of central venous CRBSI was 20.41‰-29.1‰ of patients in control group in China, the incidence per 1 000 days of central venous CRBSI was mostly <16.6‰ in control group in foreign countries, and the incidence of central venous CRBSI was decreased to varying degrees after implementing the corresponding intervention measures. Related research conclusions showed that new materials, multidisciplinary cooperation, and comprehensive preventive measures had good effects on prevention of central venous CRBSI in burn patients. Conclusions:The researches on prevention of central venous CRBSI in burn patients in China start early and the research types are diversified. The diagnostic criteria of central venous CRBSI in burn patients are not uniform, intervention measures have shifted from standardizing relevant operational measures to exploring the prevention effects of new materials, multidisciplinary cooperation, and multiple measures, and the latter has good effects on preventing central venous CRBSI in burn patients.

The Wilderness Medical Society updated and published the Wilderness Medical Society practice guidelines for the prevention and treatment of frostbite in July 2019. The guidelines provide evidence-based recommendations for the prevention and treatment of frostbite, mainly including pathophysiology, classification, prevention, and treatment of frostbite. This paper focuses on the interpretation of the guidelines, aiming at making clinical medical staff understand the new progress of frostbite treatment and providing reference for clinical practice.

Objective To explore the effect of application of task-based learning with experiential teaching on nursing clinical decision making ability. Methods A total of 96 nursing students were divided into experimental group and observation group with each of 48 nursing students. The experimental group used the application of task-based learning with experimental teaching, the control group used the traditional scenario simulation. At the end of the course, the final scores, skill operation scores and nursing students'evaluation of the course and clinical decision-making ability of nursing were observed in the two groups. Results The final scores, chapters related to task-based learning with experiential teaching, skill operation scores was (82.06±0.98), (12.01±0.88), (94.99±0.34) points in the experimental group, and (78.34±0.98), (9.32±0.76), (91.87±0.98) points in the control group, and the difference was significant(t=12.958, 9.872, 10.834, all P<0.01). The evaluation of teaching methods, teaching process and teaching effect was (20.06±0.98), (23.01±0.88), (35.99±0.34) points in the experimental group, and (17.34±0.98), (20.32±0.76), (30.87±0.98) points in the control group, and the difference was significant (t=5.96, 6.87, 6.99, all P<0.01).The score of clinical decision-making ability of nursing was (137.50 ± 12.61) points in the experimental group, and (123.88±9.89) points in the control group,and the difference was significant (t=5.891, P<0.01). Conclusions The effect of task-based learning with experiential teaching in teaching of nursing in vocational nursing students, enable students to transfer knowledge and experience in experience, it can improve the students' clinical decision making ability.

Objective: To analyze the changes of peripheral blood leukocyte in patients with Behçet uveitis (BU) at different stages. Methods: Case control study was performed.Twenty active stage BU patients and 21 quiet stage BU patients were enrolled from July to November 2015 in Peking Union Medical College Hospital.Ten active stage BU patients treated with glucocorticoid and/or immunosuppressive agents were served as improvement stage BU patients.Meanwhile, 82 healthy controls were collected from the physical examination center.Peripheral blood was obtained and then analyzed by using Hematoflow method.The percentages of leukocytes in peripheral blood of different stage BU patients were compared.This study was approved by the Ethics Committee of Peking Union Medical College Hospital (ZS-1341) and all participants signed informed consent. Results: The percentage of mature neutrophils, eosinophils, basophils, B lymphocytes, non-cytotoxic T and NK lymphocytes, granular T and NK lymphocytes, T blasts, B blasts and immature granulocytes were all significantly different among active stage BU group, quiet stage BU group and healthy control group (F=42.324, 10.220, 8.660, 11.254, 29.795, 31.305, 23.742, 27.738 and 34.638, all at P<0.001). The percentage of mature neutrophils in active stage BU group and quiet stage BU group were (73.10±10.21)% and (62.40±12.09)%, which were significantly higher than (54.95±6.07)% in healthy control group.The percentage of mature neutrophils in active stage BU group was significantly higher than that in quiet stage BU group (P<0.05). The percentages of non-cytotoxic T, NK lymphocytes, granular T and NK lymphocytes in active stage BU group and quiet stage BU group were significantly lower than that in healthy control group, the percentage of non-cytotoxic T, NK lymphocytes and granular T, NK lymphocytes in active stage BU group were significantly lower than those in quiet stage BU group (all at P<0.05). The percentage of immature granulocytes after treatment was significantly higher than that before treatment in improvement stage BU group (t=-2.469, P=0.036). Conclusions Increase of peripheral blood mature neutrophil was observed in BU patients, which may help to monitor the inflammatory activity of BU.

Telemedicine refers to two or more medical institutions using communication, computer, and network technology to provide remote diagnosis, treatment, and care for patients. The necessity and feasibility of applying telemedicine are determined by the characteristics of burn injury. This paper reviewed the application of telemedicine in burn surgery at home and abroad, then analyzed the significance and problems of using this technology in the field of burns, finally forecasted the future of application of telemedicine in burn surgery.

The increasing use of target therapy and immunocheckpoint inhibitors in cancers has brought new hope of survival to patients with advanced tumors. However, more and more adverse side-effects and toxicities of these medications had been reported, affect almost all human organs including the eye. These adverse effects may affect the entire ocular tissues, like eyelid, eye lashes, conjunctiva, cornea, uvea, retina, optic nerve and so on, which are always been ignored by patients and doctors. In this paper we will summarize the characteristics of the related ocular diseases and give our advice on how to diagnose and manage these diseases.

Objective To analyze the coincidence of the patients with capillary electrophoresis hemoglobin A 2 increase with defi-nitely diagnosed beta thalassaemia and to investigate its application value in the diagnosis of beta thalassaemia.Methods Two hundreds and sixty outpatients and inpatients with hemoglobin A 2 increase in our hospital from May 2014 to May 2015 were per-formed the genetic testing.Results Among 260 patients with hemoglobin A2 increase ,beta thalassemia gene mutations were detec-ted in 257 cases ,the coincidence rate reached 98.85% ,and the common 17 beta thalassemia gene mutations were not detected in the other 3 cases ,follow-up further detection of rare beta thalassaemia gene and beta globin gene sequencing was performed ,1 case of SEA-HPFH βdeletion type was found ,1 case was Taiwaneseβdeletion type and 1 case was Codon 89-93(-AGT GAG CTG CAC TG) heterozygous mutation ,it was verified that 3 cases of hemoglobin A2 increase without detecting 17 kinds of common beta thalassemia gene mutations were still beta chain mutation occurrence or big fragment deletion.At the same time ,among 257 speci-mens of beta thalassemia gene mutations ,42 cases were compound alpha thalassaemia ,accounting for 16.34% of beta thalassaemia. Conclusion Capillary electrophoresis hemoglobin A2 increase can provide a fast and accurate basis for beta thalassemia diagnosis , but which can not rule out the possibility of compoound alpha thalassaemia ,when the patient's hemoglobin A2 is increased ,alpha and beta thalassaemia genetic diagnosis should be simultaneously carried out.

Objective To investigate the change of plasma vitamin D, A and E levels in infant with infantile hepatitis syndrome (IHS) and to provide reliable basis for clinical treatment. Methods Seventy-three infant with IHS (IHS group) from January 2015 to May 2016 and 82 cases of physical examination infant (control group) were enrolled in this study.The levels of plasma vitamin D, A and E were tested and compared between two groups. Results The levels of vitamin D, A and E in IHS group were significantly lower than those in control group:(37.871 ± 20.111) nmol/L vs. (97.708 ± 28.827) nmol/L, (1.082 ± 0.657)μmol/L vs. (1.810 ± 0.517)μmol/L, (21.252 ± 7.596)μmol/L vs. (26.647 ± 6.495)μmol/L, P<0.01 or <0.05. The nutritional status of vitamin D, A and E in two groups had significant differences (P<0.01). Conclusions There have obvious deficiency in fat-soluble vitamin D, A and E in infant with HIS , and vitamin D deficiency is the most obvious. The levels of vitamin D, A and E are the dynamic monitoring indicators of treatment, nutritional status evaluation and long-term complications development.