Objective:To develop an evidence-based nursing practice program based on the Stetler model to extend the lifespan of arteriovenous fistulas (AVF) in maintenance hemodialysis (MHD) patients and evaluate its effectiveness.Methods:An evidence-based nursing practice program was constructed based on the best evidence for extending AVF lifespan in MHD patients. Expert group discussions were held to determine review indicators. A baseline survey was conducted among 100 MHD patients and 42 nurses using covenience sompling at the Blood Purification Center of Wuxi People's Hospital from January to December 2023, to identify barriers and facilitators. In the following year, from January to December 2024, the evidence-based practice was implemented at the same hospital, and the AVF surgical intervention rate and AVF self-management levels of MHD patients were compared before and after the practice.Results:No statistically significant difference was found in the AVF surgery rates before and after the evidence-based practice ( P>0.05) . However, after implementing the evidence-based practice, MHD patients' scores on the AVF self-management scale significantly improved, and the difference was statistically significant ( P<0.01) . Conclusions:The evidence-based practice based on the Stetler model is beneficial for standardizing the clinical management of AVF, reducing the need for surgical interventions, and improving MHD patients' ability to self-manage their AVF.

Objective:To develop an evidence-based nursing practice program based on the Stetler model to extend the lifespan of arteriovenous fistulas (AVF) in maintenance hemodialysis (MHD) patients and evaluate its effectiveness.Methods:An evidence-based nursing practice program was constructed based on the best evidence for extending AVF lifespan in MHD patients. Expert group discussions were held to determine review indicators. A baseline survey was conducted among 100 MHD patients and 42 nurses using covenience sompling at the Blood Purification Center of Wuxi People's Hospital from January to December 2023, to identify barriers and facilitators. In the following year, from January to December 2024, the evidence-based practice was implemented at the same hospital, and the AVF surgical intervention rate and AVF self-management levels of MHD patients were compared before and after the practice.Results:No statistically significant difference was found in the AVF surgery rates before and after the evidence-based practice ( P>0.05) . However, after implementing the evidence-based practice, MHD patients' scores on the AVF self-management scale significantly improved, and the difference was statistically significant ( P<0.01) . Conclusions:The evidence-based practice based on the Stetler model is beneficial for standardizing the clinical management of AVF, reducing the need for surgical interventions, and improving MHD patients' ability to self-manage their AVF.

Objective:To explore the predictive value of amplitude integrated electroencephalography(aEEG)in the neurological prognosis of children with neonatal bacterial meningitis(NBM).Methods:The clinical data and aEEG results from 148 children diagnosed with NBM who completed aEEG examinations in the Department of Neonatology at Kunming Children′s Hospital from January 2018 to December 2019 were retrospectively analyzed.According to whether aEEG is abnormal, the children were divided into aEEG abnormal group and aEEG non-abnormal group.According to the degree of aEEG abnormality, children with aEEG abnormality were divided into aEEG mild abnormal group and aEEG severe abnormal group.The abnormal rate and abnormal characteristics of aEEG were analyzed; The clinical data of two groups were compared.Results:(1)Among the 148 children with NBM, 49 children had abnormal aEEG, 99 children had no abnormality, and the aEEG abnormal rate was 33.1%.The abnormal aEEG was manifested as delayed sleep-wake cycle maturation in 39 (26.3%) cases, abnormal discharge in eight (5.4%) cases, and abnormal background activity in one (0.6%) case.(2)The proportion of children with convulsive seizures and refractory NBM in aEEG abnormal group were significantly higher than those in aEEG non-abnormal group ( P<0.05). In the routine and biochemical abnormal indexes of cerebrospinal fluid, the proportion of protein >3 g/L, cerebrospinal fluid leukocyte>500×10 6/L, cerebrospinal fluid glucose<1.5 mmol/L, positive cerebrospinal fluid culture, positive blood and cerebrospinal fluid culture, abnormal head MRI in aEEG abnormal group significantly increased ( P<0.05); While there was no significant difference regarding blood routine leukocyte abnormality, CRP increase, and positive blood culture ratio between two groups ( P>0.05). (3) 148 cases of NBM children were followed up to 15 months old, 119 (80.4%) cases completed the follow-up, the loss rate was 19.6%, three cases died, and 11 cases had psychomotor retardation.Compared with the children with abnormal aEEG, the prognosis of children with NBM was significantly different, the Spearman rank correlation coefficient r was 0.315 ( P<0.05). COX regression was used to analyze the predictive value of each index for adverse outcomes. Abnormal aEEG was an independent risk factor for adverse outcomes in children with NBM ( OR=7.452, 95% CI 1.605-34.591, P<0.05). Conclusion:The aEEG monitoring of children with NBM, if abnormal, may indicate severe NBM, which is likely to be transformed into refractory NBM or has a poor prognosis.

Objective To explore the effect of low-frequency electroacupuncture (EA) on neuropathic pain induced by spinal nerve injury and its underlying mechanism.Methods Thirty-two male Sprague-Dawley rats were randomly divided into a normal group,a sham spared nerve injury (SNI) group,an SNI group and an SNI+EA group,each of 8.The rats in the SNI and SNI+EA groups were given SNI surgery,while those of the sham-SNI group only had the sciatic nerve and its branches exposed without any lesion.EA at 2 Hz was applied over the ipsilateral Zusanli and Kunlun acupoints daily for 14 days after the surgery.The ipsilateral paw withdrawal threshold (PWT) was measured,along with protein kinase A (PKA) levels in the dorsal horn of the spinal cord,calcitonin gene-related peptide (CGRP) and substance P (SP) levels along with transient receptor potential V1 (TRPV1).Results Compared to the normal group,the SNI groups all showed significant decreases in their PWTs on the affected side and significant increases in PKA,TRPV1,CGRP and substance P on the affected side.Compared to SNI group,the average ipsilateral PWT in the SNI+EA group increased significantly after EA treatment,while PKA levels,TRPV1,CGRP levels and SP expression all decreased significantly.Conclusion Electroacupuncture at low frequency can effectively relieve neuropathic pain,perhaps through down-regulation of PKA in the spinal cord and by decreasing pain hypersensitivity related to CGRP and SP.

Objective To investigate the effect of comprehensive nursing intervention on the quality of life of urostomy patients with urinary bladder tumor.Methods A total of 70 urostomy patients who underwent urinary bladder tumor surgery in our hospital were randomly divided into observation group and control group,with 35 cases per group.The control group was given routine nursing intervention,while the observation group was given comprehensive nursing intervention,the psychological status and quality of life were compared between the two groups.Results After nursing,SAS,SDS scores of two groups were lower than treatment before,and the observation group was significantly lower than the control group,the differences were statistically significant (P ＜ 0.05);After nursing intervention,the social function,cognitive function,emotional function,role function,physical function and general health scores were higher than nursing before,but the observation group increased more (P ＜ 0.05).Conclusion Comprehensive nursing intervention for urostomy patients with bladder tumor surgery can significantly relieve the patient’s psychological pressure,promote rehabilitation,improve the quality of life and nursing satisfaction.

Objective To investigate the effect of comprehensive nursing intervention on the quality of life of urostomy patients with urinary bladder tumor.Methods A total of 70 urostomy patients who underwent urinary bladder tumor surgery in our hospital were randomly divided into observation group and control group,with 35 cases per group.The control group was given routine nursing intervention,while the observation group was given comprehensive nursing intervention,the psychological status and quality of life were compared between the two groups.Results After nursing,SAS,SDS scores of two groups were lower than treatment before,and the observation group was significantly lower than the control group,the differences were statistically significant (P ＜ 0.05);After nursing intervention,the social function,cognitive function,emotional function,role function,physical function and general health scores were higher than nursing before,but the observation group increased more (P ＜ 0.05).Conclusion Comprehensive nursing intervention for urostomy patients with bladder tumor surgery can significantly relieve the patient’s psychological pressure,promote rehabilitation,improve the quality of life and nursing satisfaction.

Objective To study the feasibility of the ultrasonic scalpel in the management of cystic blood vessels during laparoscopic cholecystectomy(LC). Methods Abdominal blood vessels of two dogs were managed by ultrasonic scalpel under the conditions of two step output power,low tension,low holding force and blunt scalpel head.The blood vessels were sealed and arteries and veins of (1～11)mm were cut.On this basis,the technique was applied to the management of cystic vessels during laparoscopic cystic and biliary operation. Results The sealing and cutting effect was good for the blood vessels of less than 9mm 140/150(93 3%).No blood oozing was found at the cutting ends of blood vessels during and after operation.In all 706 cases of laparoscopic gallbladder and biliary duct operations,no bleeding was found at the cutting ends of blood vessels during and after operation. Conclusions Ultrasonic scalpel can be directly used to seal and cut cystic artery during laparoscopic cholecystectomy.

Objective: To study the contents and constituents of LSPC (procyanidins from Lotus Seedpod) and its chemoprophylactic effects on 9,10-dimethyl-1,2-benzanthracene (DMBA)-induced golden hamsters buccal-pouch carcinomas. Methods: ESI-MS was used to analyze LSPC, and the change of body weight, mortality during test, and the value of serum MDA, GSH-Px, T-SOD,the gross and pathological change of buccal-pouch mucosa were investigated when golden hamsters were via gastric intubation or the buccal pouch mucosa was smeared with 100mg/(kg bw?d)LSPC. Results and conclusion: The contents of LSPC exceeded 98% and mono-, di-, tri-, tetrameric procyanidins as well as di-, trimeric galic ester were constituted of LSPC with molecular weight ranging from 290-1154. LSPC had chemoprophylactic effects on DMBA-induced golden hamsters buccal-pouch carcinomas, and the effect was superior through smearing LSPC rather then via gastric intubation .