Objective To summarise the evidence on nutritional management in adults with metabolic dysfunction-associated fatty liver disease(MAFLD),therefore to provide a guidance for clinical practice.Methods According to the"6S"model,literature on the nutritional management in adult MAFLD were retrieved from domestic and international databases and websites,including National Guide Library of the United States,National Institute for Health and Care Excellence,Guidelines International Network,the American Association for the Study of the Liver Disease,Europe Association for the Study of the Liver,Asian Pacific Association for the Study of the Liver,American Association of Clinical Endocrinologists,Italian Association for the Study of the Liver,European Society of Clinical Nutrition and Metabolism,American Society for Parenteral and Enteral Nutrition,BMJ Best Practice,UpToDate,Joanna Briggs Institute(JBI)Evidence database,PubMed,Cochrane Library,Web of Science,Embase,CINAHL,Medlive,CNKI,VIP,Wanfang,China Biology Medicine,from the inception of databases to 1st March,2024.The literature included guidelines,expert consensus,recommended practices,systematic reviews and evidence summaries.Two researchers independently evaluated the quality of literature and extracted data to summarise the best evidence.Results A total of 24 publication were finally included,with 36 pieces of best evidence summarised,covering six themes:assessment and goals,dietary patterns,diet structure,dietary supplements,exercise guidance and health education.Conclusion The best evidence on nutritional management summarised in this study provides the evidence-based support for healthcare providers with better nutritional management for adult MAFLD,it also offers a guidance in formulation of individualised nutritional management plans.

Objective To explore the pioneering symptoms of the gastrointestinal symptom cluster and their influencing factors in gastric cancer patients with chemotherapy.Methods Based on the hospital's management system for scientific research data,463 gastric cancer patients with chemothera-py were surveyed through multicenter collaboration by the corresponding module of the MD Anderson Symptom Inventory(MDASI),the Chinese Medicine Constitution Classification and Identification Standard,and the Chinese Medicine SyndromeIdentification Standard for Gastric Cancer.IBM SPSS Statistic 22.0 and IBM SPSS Modeler 18.0 were used for data analysis.Results The first occurrence of dry mouth in the gastrointestinal symptom cluster of gastric cancer patients with chemotherapy was(22.99±10.70)hours after chemotherapy.The support,confidence,and lift for the association be-tween dry mouth and decreased appetite were 62.2％,94.8％and 1.52,respectively;for dry mouth and nausea,the numerical values were 62.2％,89.6％and 1.44;for dry mouth and vomiting,the numerical values were 62.2％,79.5％and 1.28.The results of one-way ANOVA and multivariate linear regression analysis showed that alcohol consumption,syndrome of stomach heat injuring yin,and phlegm-dampness constitution were independent influencing factors for dry mouth in gastric cancer patients with chemotherapy(P＜0.05).Conclusion Dry mouth,as a pioneering symptom of the gastroin-testinal symptom cluster,is of great significance in clinical assessment and management.Improved assessment of dry mouth can provide a basis for the construction of subsequent risk prediction model,the formulation of targeted interventions,and the enhancement of symptom management efficiency.

Objective To summarise the evidence on nutritional management in adults with metabolic dysfunction-associated fatty liver disease(MAFLD),therefore to provide a guidance for clinical practice.Methods According to the"6S"model,literature on the nutritional management in adult MAFLD were retrieved from domestic and international databases and websites,including National Guide Library of the United States,National Institute for Health and Care Excellence,Guidelines International Network,the American Association for the Study of the Liver Disease,Europe Association for the Study of the Liver,Asian Pacific Association for the Study of the Liver,American Association of Clinical Endocrinologists,Italian Association for the Study of the Liver,European Society of Clinical Nutrition and Metabolism,American Society for Parenteral and Enteral Nutrition,BMJ Best Practice,UpToDate,Joanna Briggs Institute(JBI)Evidence database,PubMed,Cochrane Library,Web of Science,Embase,CINAHL,Medlive,CNKI,VIP,Wanfang,China Biology Medicine,from the inception of databases to 1st March,2024.The literature included guidelines,expert consensus,recommended practices,systematic reviews and evidence summaries.Two researchers independently evaluated the quality of literature and extracted data to summarise the best evidence.Results A total of 24 publication were finally included,with 36 pieces of best evidence summarised,covering six themes:assessment and goals,dietary patterns,diet structure,dietary supplements,exercise guidance and health education.Conclusion The best evidence on nutritional management summarised in this study provides the evidence-based support for healthcare providers with better nutritional management for adult MAFLD,it also offers a guidance in formulation of individualised nutritional management plans.

Objective To investigate the incidence and severity of symptoms in patients with gastric cancer who received chemotherapy,we constructed a symptom network to explore core symptoms and bridge symptoms.Furthermore,the study explores the association between core symptoms and Traditional Chinese Medicine(TCM)constitutions.Methods Patients with gastric cancer who received chemotherapy in the medical oncology and surgical oncology department from March to August 2023 were selected for the study using a convenience sampling method.The MD Anderson Symptom Inventory Gastrointestinal Cancer was used for evaluating gastrointestinal symptoms and their severity among patients receiving chemotherapy for gastric cancer,as well as assessing the classification of TCM constitution among patients.The symptom network model was constructed using the R programming language,and the central index was analyzed to determine the core symptoms and bridge symptoms.Binary logistic regression analysis was employed to assess the association between different physical conditions and the occurrence of core symptoms.Results A total of 346 electronic questionnaires were collected,with 340 valid ones,and the effective recovery rate was 98.3％.The 3 most prevalent and severe symptoms among the 340 patients with gastric cancer were fatigue(85.59％),lack of appetite(82.35％),and taste alteration(81.18％).The centrality index results indicated that grief exhibited the highest intensity,medium,and compactness centrality values(rs=8.23,rb=2.00,rc=0.03),making it the core symptom of this condition.Sleep disorders,lack of appetite,drowsiness,and taste alteration were identified as bridging symptoms with bridge intensities of 0.74,0.76,0.99,and 0.94 respectively.The results of Spearman correlation analysis showed that there was a positive correlation between sadness and qi-deficiency constitution,phlegm-dampness constitution(P＜0.05).The phlegm-dampness constitution was positively correlated with the taste alterations(P＜0.05).Conclusion In patients with gastric cancer,fatigue emerges as the most prominent symptom,while sadness assumes the core symptom.Additionally,sleep disorder,lack of appetite,drowsiness,and taste alteration are bridge symptoms.According to the principles of TCM constitution,qi-deficiency and phlegm-dampness are constitutions associated with a higher risk of experiencing sadness,and phlegm-dampness is a constitution associated with a higher risk of taste changes.Nurses can integrate core symptoms and TCM constitutions characteristics to optimize the strategies for symptom intervention.

Objective: To explore the possible types of patients with gastric cancer undergoing chemotherapy based on their experience with the symptom cluster of pain, fatigue, sleep disturbance. Methods: Totally 161 gastric cancer patients were investigated by the demographic and clinical characteristics questionnaire, the Numeric Rating Scale (NRS), the Brief Fatigue Inventory (BFI), the Pittsburgh Sleep Quality Index (PSQI), Quality of Life Questionnaires (QLICP-ST). Cluster analysis using SPSS 22.0 version was performed to categorize patients. Results: Four different types of patients were got through cluster analysis. Type Ⅰ patients showed all low symptoms (23 cases accounted for 14.3%), Type Ⅱ patients showed low pain and moderate fatigue (43 cases accounted for 26.7%), Type Ⅲ patients showed low pain and high fatigue (62 cases accounted for 38.5%), Type Ⅳ patients performed moderate-to-high on all symptoms (33 cases accounted for 20.5%). Their education status, chemotherapy cycle sand KPS score were the main factor influencing the classification of pain-fatigue-sleep disorder symptoms in patients with gastric cancer undergoing chemotherapy after operation (χ²=13.873, 26.442, F=3.193, P<0.05 or 0.01). Type Ⅳ tended to have higher education level, lower KPS score and later stage of chemotherapy. Furthermore, patients in moderate-to-high class had significantly lower quality of life score than all low class (F=10.552, P <0.01). Conclusion In this research, patients with gastric cancer undergoing chemotherapy were divided into 4 types based on their experience with the symptom cluster of pain, fatigue and sleep disturbance. It could provide basis for effectively screening and implementing measures for symptoms management.

Objective? To review the intervention effects of auricular-plaster therapy on adults with anxiety systematically. Methods? Data about random controlled trails of auricular-plaster therapy in treating anxiety were collected from Cochrane, PubMed, Embase, CBMdisc, CNKI and Wanfang databases. The quality of literatures were assessed and the data were collected by two persons independently. Multiple-time-point Meta-analysis was used for anxiety, while endpoint Meta-analysis was used for quality of sleep and life. RevMan 5.3 was used for statistical analysis. Results? Totally 15 literatures were included in this study, involving 890 subjects. Meta-analysis showed that auricular-plaster therapy could ameliorate anxiety continuously with high degrees within 2 months (P＜ 0.01), but there were no notable effects yet beyond 2 months (P＞ 0.05). Auricular-plaster therapy could improve the quality of sleep effectively (P＜0.001). There was no evidence that auricular-plaster therapy could improve the quality of life (P＞0.05). Conclusions? Auricular-plaster therapy can ameliorate patients' anxiety and improve their quality of sleep, but considering the limited quality and quantity of studies included, the findings of our study will need to be tested by multicenter and high-quality random controlled trails with large samples, especially its long-term intervention effects.

Objective To investigate the effects of artificial airway cuff pressure at different monitoring intervals on ventilator associated pneumonia (VAP) in critical patients. Methods About 56 patients treated with mechanical ventilation from January 2015 to December were grouped by ward numbers:32 patients in the south ward were in the experiment group and 24 in the north ward were in the control group. The two groups were given the same routine care, e.g., mechanical ventilation by endotracheal intubation. In the experiment group, the cuff pressure was controlled to 30cm H2O every six hours and the control group was every 4h. The two groups were compared in terms of the incidence of VAP during mechanical ventilation, occurrence time of VAP, duration of mechanical ventilation and mortality. Result The incidence of VAP during mechanical ventilation, occurrence time of VAP, duration of mechanical ventilation, and mortality showed no significant differences between the two groups (P>0.05). Conclusions For mechanically ventilated patients, the cuff pressure controlled to 30cm H2O every 6h can not increase the incidence of VAP, duration of mechanical ventilation and mortality. It can reduce the nursing workload.

Objective To investigate the intervention effect of herbal plaster on appetite loss of patients with gastrointestinal cancer undergoing chemotherapy.Methods Sixty-six patients treated in Department of Oncology, Affiliated Hospital of Nanjing University of Chinese Medicine from August 2015 to August 2016 were selected by convenient sampling, and were divided randomly into two groups. Patients in the control group were given conventional nursing, while patients in the observation group were given extra application of herbal plaster. The effect of intervention was evaluated by change of the patients' appetite and BMI.Results After completion of the treatment, appetite scores of patients in the observation group were (4.55±1.32) points, with that in the control group (2.22±1.43) (t=5.48,P<0.05); difference of BMI between the two groups showed no statistic significance (t=0.89,P>0.05).Conclusions Herbal plaster, as a characteristic technique in external treatment of traditional medicine, can help the patients regain their appetite to a certain extent and thus improve clinical outcomes. Still, clinical quantity-effect researches need to be strengthened in the future, so as to make the results more stringent, to better popularize and promote traditional Chinese nursing technology, and to provide new ideas and complementary therapy for clinical application of appetite loss caused by chemotherapy.

Objective To investigate the risk factors for contact dermatitis in patients with peripherally inserted central catheter (PICC) catheterization.Methods A total of 244 patients with PICC catheterization admitted in the Venous Catheter Nursing Outpatient of Affiliated Hospital of Nanjing University of TCM from June to August 2016 were selected using convenience sampling. A prospective study was performed on those patients for general information, PICC catheter information, PICC care information and contact dermatitis development information. SPSS 21.0 was used to analyze the date.Results A number of 24 patients were observed to have contact dermatitis with an incidence of 9.84%. Single factor analysis showed that gender, age, allergy, dressing type and catheter material correlated to the development of contact dermatitis with PICC. The differences were statistically significant (P<0.05). Multiple factor logistic regression analysis showed that the gender[OR=2.721, 95%CI (1.059-6.994),P=0.038], allergy[OR=5.846, 95%CI (2.030-16.833),P=0.001] and dressing type[OR=4.055, 95%CI (1.472-11.169),P=0.007]were risk factors of contact dermatitis in patients with PICC catheterization.Conclusions For PICC catheterization patients, effective preventive measures aiming at risk factors can reduce the occurrence of contact dermatitis with PICC.

OBJECTIVETo compare the difference in the therapeutic effect on post-infectious cough differentiated as wind-cold retention in the lung between the combined therapy of scraping anddecoction and the simple application ofdecoction.

METHODSEighty patients were randomized into a combined therapy group and a Chinese herbal medicine group, 40 cases in each one. In the Chinese herbal medicine group, the oral administration ofdecoction was used. The main ingredients included,,,,,,,, etc., one dose a day, twice a day. In the combined therapy group, on the basis of the treatment as the Chinese herbal medicine group, scraping therapy was added and applied to the bladder meridian of foot-, the lung meridian of hand-, the conception vessel and the governor vessel, focusing on Tiantu (CV 22), Baihui (GV 20), Dazhui (GV 14), Feishu (BL 13), Fengmen (BL 12), Taiyuan (LU 9), Lieque (LU 7) and Fengchi (GB 20), once a week and one-week treatment as one session. Totally, the continuous two sessions were required in the two groups. The cough symptom score, cough remission time, relapse, TCM syndrome score, the score of Leicester cough questionnaire (LCQ), SP concentration in the supernatant of the induced sputum before and after treatment as well as clinical efficacy were observed in the two groups.

RESULTSThe cough symptom score, TCM symptom score and SP concentration in the supernatant of the induced sputum were all apparently reduced after treatment in the patients of the two groups (all<0.01). The scores in the combined therapy group were reduced in the higher amplitude as compared with those in the Chinese herbal medicine group (all<0.01). The total effective rate was 95.0% (38/40) in the combined therapy group, better than 87.5% (35/40) in the Chinese herbal medicine group (<0.05). Regarding the cough remission time and relapse rate, the results in the combined therapy group were better than those in the Chinese herbal medicine group[(5.3±1.2) d vs (7.4±1.5) d,<0.01; 0% (0/19) vs 62.5% (5/8),<0.01]. The scoreo of LCQ was all apparently improved in the patients of the two groups (both<0.01), and the score in the combined therapy group was higher than that in the Chinese herbal medicine group (<0.01).

CONCLUSIONSScraping therapy combined withdecoction and the simple application ofdecoction all relieve the symptoms of post-infectious cough and improves the living quality. The therapeutic effects of the combined therapy are superior to the oral administration ofdecoction.