Objective To develop and validate a safety assessment scale for early mobilization in lung transplant patients after surgery.Methods From September 2022 to April 2023,a preliminary scale was constructed using literature analysis,expert meetings,and the Delphi method.From June 2023 to May 2024,a convenience sampling was used to select 135 patients admitted to the lung transplant center of a tertiary general hospital in Jiangsu Province.Item analysis,reliability analysis,and validity analysis were applied to adjust the items,forming the final scale.Results The post-operative early mobilization safety assessment scale for lung transplant patients includes 5 dimensions(consciousness level,vital signs,disease-related factors,mobility,and nutritional status)and 18 items.The inter-rater reliability of the scale is 0.985;the overall content validity index is 0.853;the split-half reliability is 0.716.The area under the receiver operating characteristic curve for predicting adverse events within 72 hours of mobilization is 0.845,with a 95％confidence interval of 0.767 to 0.917(P＜0.001).The optimal cutoff value is 18.5,with a sensitivity of 0.735 and a specificity of 0.782.Conclusion The developed safety assessment scale for early mobilization in lung transplant patients after surgery demonstrates good reliability and validity,and it can serve as a clinical tool to assess the safety of early mobilization activities in these patients.

Objective To understand the current situation and influencing factors of delirium in lung transplant patients in the early postoperative period,and to construct and verify a risk prediction model.Methods The convenience sampling method was used to select patients who were admitted to a tertiary general hospital in Jiangsu Province for lung transplantation from June 2023 to November 2024.Lasso regression was used to screen variables,and logistic regression analysis was used to explore the influencing factors of early postoperative delirium in lung transplantation patients,and the risk prediction model was constructed and nomogram was drawn.The area under the working curve(AUC)of the subjects and the Hosmer-Lemeshow test were used to evaluate the discrimination and calibration of the model.Internal validation of the model was performed by repeated sampling 1000 times using Bootstrap method.Results A total of 228 lung transplant patients were included in this study,of which 76 developed delirium in the early postoperative period,with an incidence of 33.33％.Age≥51.5 years,hypertension combined with diabetes mellitus,the Lung Allocation System(LAS)score ≥ 75.63,the duration of mean arterial pressure less than 70 mmHg≥ 12.50 min,intraoperative red blood cell transfusion≥750 ml,and midazolam dosage≥102.50 mg were the independent risk factors for early postoperative delirium in lung transplantation(P＜0.05).The AUC of the model was 0.771;the optimal cut-off value was 0.334;the sensitivity and specificity were both 0.724.The results of Hosmer-Lemeshow test showed that x2=5.677,P=0.683;the internal verification showed that the AUC of the model was 0.737,and the absolute error of the actual and predicted values of the calibration curve was 0.023,and the calibration curve was close to the ideal curve.Conclusion Age,hypertension combined with diabetes mellitus,LAS score,duration of mean arterial pressure less than 70 mmHg,amount of intraoperative red blood cell transfusion,and midazolam dosage are the influencing factors for early postoperative delirium in lung transplant patients.The risk prediction model constructed in this study has good predictive performance and can be used as a risk prediction tool for early postoperative delirium in lung transplant patients,helping to timely and accurately identify high-risk groups of delirium,helping to reduce the incidence of early postoperative delirium,and improve patient prognosis.

Objective To understand the current situation and influencing factors of delirium in lung transplant patients in the early postoperative period,and to construct and verify a risk prediction model.Methods The convenience sampling method was used to select patients who were admitted to a tertiary general hospital in Jiangsu Province for lung transplantation from June 2023 to November 2024.Lasso regression was used to screen variables,and logistic regression analysis was used to explore the influencing factors of early postoperative delirium in lung transplantation patients,and the risk prediction model was constructed and nomogram was drawn.The area under the working curve(AUC)of the subjects and the Hosmer-Lemeshow test were used to evaluate the discrimination and calibration of the model.Internal validation of the model was performed by repeated sampling 1000 times using Bootstrap method.Results A total of 228 lung transplant patients were included in this study,of which 76 developed delirium in the early postoperative period,with an incidence of 33.33％.Age≥51.5 years,hypertension combined with diabetes mellitus,the Lung Allocation System(LAS)score ≥ 75.63,the duration of mean arterial pressure less than 70 mmHg≥ 12.50 min,intraoperative red blood cell transfusion≥750 ml,and midazolam dosage≥102.50 mg were the independent risk factors for early postoperative delirium in lung transplantation(P＜0.05).The AUC of the model was 0.771;the optimal cut-off value was 0.334;the sensitivity and specificity were both 0.724.The results of Hosmer-Lemeshow test showed that x2=5.677,P=0.683;the internal verification showed that the AUC of the model was 0.737,and the absolute error of the actual and predicted values of the calibration curve was 0.023,and the calibration curve was close to the ideal curve.Conclusion Age,hypertension combined with diabetes mellitus,LAS score,duration of mean arterial pressure less than 70 mmHg,amount of intraoperative red blood cell transfusion,and midazolam dosage are the influencing factors for early postoperative delirium in lung transplant patients.The risk prediction model constructed in this study has good predictive performance and can be used as a risk prediction tool for early postoperative delirium in lung transplant patients,helping to timely and accurately identify high-risk groups of delirium,helping to reduce the incidence of early postoperative delirium,and improve patient prognosis.

Objective To develop and validate a safety assessment scale for early mobilization in lung transplant patients after surgery.Methods From September 2022 to April 2023,a preliminary scale was constructed using literature analysis,expert meetings,and the Delphi method.From June 2023 to May 2024,a convenience sampling was used to select 135 patients admitted to the lung transplant center of a tertiary general hospital in Jiangsu Province.Item analysis,reliability analysis,and validity analysis were applied to adjust the items,forming the final scale.Results The post-operative early mobilization safety assessment scale for lung transplant patients includes 5 dimensions(consciousness level,vital signs,disease-related factors,mobility,and nutritional status)and 18 items.The inter-rater reliability of the scale is 0.985;the overall content validity index is 0.853;the split-half reliability is 0.716.The area under the receiver operating characteristic curve for predicting adverse events within 72 hours of mobilization is 0.845,with a 95％confidence interval of 0.767 to 0.917(P＜0.001).The optimal cutoff value is 18.5,with a sensitivity of 0.735 and a specificity of 0.782.Conclusion The developed safety assessment scale for early mobilization in lung transplant patients after surgery demonstrates good reliability and validity,and it can serve as a clinical tool to assess the safety of early mobilization activities in these patients.

Objective To develop a symptoms assessment scale for lung transplant recipients in early postoperative period,and assess its reliability and validity so as to provide clinical staff with a tool to evaluate the symptoms in the patients in the early period after lung transplantation.Methods With a symptom experience model,a preliminary item pool was established through literature reviews,semi-structured interviews and expert panel meetings between December 2021 and January 2022.Based on the preliminary item pool,an initial scale was proposed after two rounds of expert consultation between February and March 2022.The initial scale was finalised after all items had revised for language expression based on the results of cognitive interviews conducted in March 2022.Subsequently,the final version of the scale was applied in the survey of 116 recipients of lung transplant in the early postoperative stage at Wuxi People's Hospital between April 2022 and February 2023.The reliability and validity of scale were then further tested.Results A total of 112 patients responded to the questionnaire survey.The developed scale comprised 5 dimensions:psychology-related symptoms,respiratory related symptoms,digestive related symptoms,circulatory related symptoms and other symptoms,with 18 symptom items in total.Content validity indexes of the Item-level content validity index(I-CVI))were 0.833 to 1.000 and the Scale-level content validity index(S-CVI)was at 0.954.Exploratory factor analysis revealed five common factors with a cumulative variance contribution rate of 82.366%.All the factors exhibited positive correlations with the scale,with the correlation coefficient at 0.760 to 0.837(P<0.01).The scale demonstrated a Cronbach α coefficient of 0.943,and the Cronbach α coefficients of the five common factors ranged from 0.869 to 0.941.Additionally,the scale exhibited a split-half reliability of 0.840,and the split-half reliability of the five common factors ranged from 0.830 to 0.937.Conclusions The symptoms assessment scale for lung transplant recipients in early postoperative period developed in this study exhibits good reliability and validity.It is feasible for evaluation of early symptoms in lung transplant recipients.

Objective:To conduct a scoping review of the characteristics, functions, risk of bias and applications of home-based self-management behavior assessment tools for lung transplant patients, so as to provide references for clinical medical staff to conduct further related research.Methods:The relevant literatures were systematically searched in China National Knowledge Infrastructure, Wanfang Database, VIP, China Biology Medicine disc, PubMed, Web of Science Core Collection, Embase, Cochrane Library and CINAHL databases. The search period was from the establishment of the databases to June 30, 2023. The scoping review method framework was used to screen the literature, extract information and standardize the report.Results:A total of 10 167 Chinese and English literatures were searched, and after deduplication and screening, 23 articles that met the criteria were finally included, involving 13 home-based self-management behavior assessment tools for lung transplant patients, including nine specific tools and four universal tools. There were eight kinds of lung transplantation patients whose reliability and validity were not verified. Of the 13 tools, those with single-dimensional assessments and single measures predominate. The level of home self-management behavior of lung transplant patients was reflected mainly through compliance, and medication management was the most frequently assessed content.Conclusions:At present, the measurement of home-based self-management behavior of lung transplant patients is mainly based on questionnaire surveys, and the evaluation tools are mostly single dimensional. The reliability and validity of most evaluation tools in the population of lung transplant patients are not yet clear, and there is a certain risk of bias. It is recommended that researchers pay attention to the reliability and validity verification report of the evaluation tool in the target population when selecting it, and integrate multiple measurement methods to reduce measurement errors.

Objective:To explore the nutritional knowledge, attitude and practice (KAP) in patients during the waiting period for lung transplantation, analyze its influencing factors, and provide a reference for individualized nutritional intervention during the perioperative period of lung transplantation.Methods:Totally 240 patients during the waiting period for lung transplantation after lung transplantation evaluation in The Respiratory Center, Wuxi People's Hospital between January and December 2018 were selected using convenient sampling, and investigated with the self-made nutritional KAP questionnaire for patients during the waiting period for lung transplantation. And the influencing factors to their nutritional KAP were analyzed.Results:The nutritional knowledge of patients during the waiting period for lung transplantation was average, with a score of (18.71±4.53) ; the nutritional attitude was good, with a score of (38.00±6.49) ; the nutritional practice was average, with a score of (36.75±4.89) . Multiple linear regression analysis showed that the influencing factors of nutritional knowledge were economic status and whether it was complication with neurological diseases ( P<0.05) ; the influencing factors of nutritional attitude were occupation and serum protein ( P<0.05) ; the influencing factors of nutritional practice were age, educational level and whether it was complicated with urinary system disease ( P<0.05) . Conclusions:The nutritional KAP of patients during the waiting period for lung transplantation is affected by age, economic status, comorbidity, occupation and educational level and serum protein. In the perioperative nutritional management of lung transplantation patients, we should fully consider various factors, provide targeted and precision nutritional interventions, improve the nutritional practice and status of patients by improving their nutritional knowledge and attitude.

Objective To summarize the successful application experience of intra-hospital transport of 13 H7N9 avian influenza patients from the general wards to the avian influenza ward. Methods Form the expert group, to determine the design target and principle of the standardized workflow and point out the operation points of standard workflow in intra-hospital transport of each link. Results The standardized workflow included the disposal of the transfer notice, condition assessment, department contact,patient preparation,object preparation,custody transfer personnel preparation,transit guardianship and transfer to the avian influenza ward,a total of eight procedures.Between January 2013 and March 2017,13 cases were successfully transfered.All patients safely arrived avian influenza ward. The process was quick and smooth.Nobody was died or rescued within 1 h after transport. Conclusions The main differences of intra-hospital transport between H7N9 avian influenza patients and general critically ill patients are the transit time control, the particularity of terminal disposal, transshipment arrangement and hospital infection management personnel involved in the whole process.

Objective To explore the effect of diabetic liaison nurses on controlling blood sugar levels in patients with hyperglycemia in department other than endocrinology. Methods Four hundred diabetic patients with high blood sugar were selected from January to December, 2014 in department other than endocrinology. They were divided randomly into 2 groups equally:the control group and the observation group. The control group received traditional nursing care, while blood sugar management was carried out by diabetic liaison nurse in the observation group. Result Pre-discharge sugar metabolism in the observation group was significantly better than that in the control group (P<0.05). Conclusion The diabetic liaison nurses in other departments than the endocrinology department can help control blood sugar levels in patients with hyperglycemiain.

Objective To summarize the experience of applying choledochoscopy, duodenoscopy and laparoscopy, one-stage suturing of common bile duct, to treat cholecystolithiasis and choledocholithiasis that failed to respond to ordinary endoscopic sphincterotomy (EST). Methods Retrospectively analyzed the clinical data of twenty-five pa-tients with choledocholithiasis complicated with cholecystolithiasis. 25 cases of failure to endoscopic stone extraction underwent LC and laparoscopic common bile duct exploration with primary suture of (BD) from June 2013 to June 2015. Results One patient was converted to laparotomy with small incision. The other one had residual stones and therefore underwent a second EST. After the treatment, two patients developed hyperamylasemia, which was cured by conservative therapy; One patient had bile leakage, which was treated by percutaneous drainage with no serious complications and death. No long-term complication was found in a portion of patients followed up until now. Conclusion In properly selected patients of duodenoscopy management-failed, synchronous treatment of combined application of three endoscopies in laparoscopic surgery with primary suture of (BD) is feasible, effective and safe.