Objective To compare the clinical efficacy and safety of early endovascular treatment(EVT)for the stroke patients caused by large vessel occlusion(LVO)due to intracranial atherosclerosis(ICAS)or due to cardioembolism(CE).Methods The clinical data of 488 patients with acute anterior circulation LVO stroke,who received early endovascular treatment at the Yijishan Hospital of Wannan Medical College of China from October 2015 to December 2023,were retrospectively analyzed.According to the cause of disease,the patients were divided into ICAS group(n=108)and CE group(n=380).The clinical data,mainly including the proportion of patients having a good prognosis at 90 days after operation(modified Rankin Scale score ≤2 points),the incidence of symptomatic intracranial cerebral hemorrhage(sICH),and the mortality of patients at 90 days after operation.Multivariate logistic regression analysis was used to analyze the factors influencing patient's prognosis.Results Of the 488 patients,29(5.9％)developed postoperative sICH,242(49.6％)achieved a good prognosis at 90 days after the operation,and 91(18.6％)died.The above outcomes in the ICAS group were one,66,and 11 patients respectively,which in the CE group were 28,176,and 80 respectively,and the differences between the two groups were statistically significant(all P＜0.05).Multivariate logistic regression analysis indicated that good prognosis at 90 days after the operation(OR=0.962,95％CI:0.404-2.288,P=0.930)and the postoperative 90-day mortality(OR=1.379,95％CI:0.436-4.362,P=0.584)were not the factors influencing prognosis,while the postoperative sICH(OR=19.132,95％CI:1.332-274.791,P=0.030)was the factor influencing prognosis.Conclusion In CE group,the incidence of sICH and the postoperative 90-day mortality are higher,while in ICAS group,the postoperative 90-day good prognosis rate is higher.The postoperative sICH is the factor influencing prognosis.

Objective:To construct a humanistic care nursing program for adult ICU patients, providing guidance for the clinical practice of humanistic care in ICUs.Methods:Based on a literature review and clinical practice experience, a preliminary humanistic care nursing program for adult ICU patients was drafted. From August to September 2024, the Delphi method was used to conduct two rounds of expert consultation with 16 experts to revise the content of each item and the overall program, resulting in the final version of the humanistic care nursing program for ICU adult patients. The experts' engagement was measured by the effective response rate of the questionnaires, their authority by the expert authority coefficient, and the coordination of expert opinions by the Kendall's coefficient of concordance.Results:The effective response rate for the Delphi expert consultation questionnaires was 100.00% (16/16) in both rounds. The expert authority coefficients were 0.872 and 0.875, respectively. After the second round of consultation, the Kendall's coefficients for the importance, applicability, and feasibility of each level of item ranged from 0.119 to 0.313 ( P<0.05). The final humanistic care nursing program for adult ICU patients included three first-level items, 12 second-level items, and 55 third-level items. Conclusions:The humanistic care nursing program for adult ICU patients constructed in this study is scientific, targeted, and feasible, providing guidance for the clinical practice of humanistic care in ICU settings.

Objective:To explore the lived experiences of family members of terminal ICU patients regarding their humanistic care needs and provide theoretical foundations for developing nursing care plans tailored to their needs.Methods:This study was a descriptive qualitative study. From April to December 2023, 16 family members of terminally ill ICU patients in Shanghai East Hospital, Tongji University were selected for semi-structured interviews using purposive sampling method, and the interview data were qualitatively analyzed using Colaizzi 7-step analysis.Results:The humanistic care needs of family members of terminally ill ICU patients can be categorized into five themes, namely, the need to know the condition at the first time; the need to participate in treatment and decision-making; the need to respect the wishes of terminally ill patients; the need for psychological care; and the need for social support.Conclusions:The humanistic care needs of family members of terminal ICU patients remain largely unmet. Nursing professionals should consider these needs and preferences and provide family members with professional guidance to help them establish positive coping mechanisms.

Objective To explore the circRNA expression level in the urine of patients with lupus nephritis(LN),to construct a diagnostic model for LN,and to evaluate and verify its diagnostic efficacy.Methods A total of 120 patients with LN admitted from January 2022 to January 2024 were selected as the observation group and divided into the training group(n=84)and the validation group(n=36)at a ratio of 7:3.Another 100 healthy individuals who underwent physical examination were selected as the control group.The expression levels of circRNA-0001445,circRNA-002059,hsa-circ-0007385 and hsa-circ-0000006 in urine specimens of patients in the training group and the control group were detected by gene sequencing.Multivariate Logistic regression analysis was used to construct a diagnostic model for LN based on the urinary circRNA expression level.The diagnostic value of individual indicators and combined predictive models were evaluated by receiver operating characteristic(ROC)curve analysis,and then the predictive efficacy of the model was verified by the validation group.Results The expression levels of circRNA-0001445,circRNA-002059,hsa-circ-0007385 and hsa-circ-0000006 in the urine of patients in the training group were all higher than those of the control group(P<0.01).Multivariate Logistic regression analysis found that The expression levels of circRNA-0001445(OR=1.094),circRNA-002059(OR=1.040),hsa-circ-0007385(OR=1.033),and hsa-circ-0000006(OR=1.130)in theurine were independent factor for the diagnosis of LN(P<0.01).ROC curve analysis showed that the areas under the curve of combined model constructed based on the circRNA expression level in the urine were 0.985 and 0.911 in the training group and the validation group,respectively,with sensitivities of 95.00%and 91.67%,and specificities of 99.00%and 89.00%,all of which were higher than the diagnostic efficacy of a single urinary circRNA expression level.Conclusion The diagnostic model of LN constructed based on the expression level of circRNA in the urine has a high diagnostic efficacy,which has been confirmed by internal tests and may provide strong support for clinicians in the early diagnosis of LN.

This paper explores the application and advancements of cross-cultural nursing concepts in the management of ICU patients. It identifies the core elements of humanistic care from a cross-cultural perspective, introduces relevant international research findings, and provides an in-depth analysis of existing challenges within the domestic healthcare context. Constructive suggestions are proposed to enhance the quality of life of ICU patients.

Objective:To construct a humanistic care nursing program for adult ICU patients, providing guidance for the clinical practice of humanistic care in ICUs.Methods:Based on a literature review and clinical practice experience, a preliminary humanistic care nursing program for adult ICU patients was drafted. From August to September 2024, the Delphi method was used to conduct two rounds of expert consultation with 16 experts to revise the content of each item and the overall program, resulting in the final version of the humanistic care nursing program for ICU adult patients. The experts' engagement was measured by the effective response rate of the questionnaires, their authority by the expert authority coefficient, and the coordination of expert opinions by the Kendall's coefficient of concordance.Results:The effective response rate for the Delphi expert consultation questionnaires was 100.00% (16/16) in both rounds. The expert authority coefficients were 0.872 and 0.875, respectively. After the second round of consultation, the Kendall's coefficients for the importance, applicability, and feasibility of each level of item ranged from 0.119 to 0.313 ( P<0.05). The final humanistic care nursing program for adult ICU patients included three first-level items, 12 second-level items, and 55 third-level items. Conclusions:The humanistic care nursing program for adult ICU patients constructed in this study is scientific, targeted, and feasible, providing guidance for the clinical practice of humanistic care in ICU settings.

Objective:To explore the lived experiences of family members of terminal ICU patients regarding their humanistic care needs and provide theoretical foundations for developing nursing care plans tailored to their needs.Methods:This study was a descriptive qualitative study. From April to December 2023, 16 family members of terminally ill ICU patients in Shanghai East Hospital, Tongji University were selected for semi-structured interviews using purposive sampling method, and the interview data were qualitatively analyzed using Colaizzi 7-step analysis.Results:The humanistic care needs of family members of terminally ill ICU patients can be categorized into five themes, namely, the need to know the condition at the first time; the need to participate in treatment and decision-making; the need to respect the wishes of terminally ill patients; the need for psychological care; and the need for social support.Conclusions:The humanistic care needs of family members of terminal ICU patients remain largely unmet. Nursing professionals should consider these needs and preferences and provide family members with professional guidance to help them establish positive coping mechanisms.

Objective To explore the circRNA expression level in the urine of patients with lupus nephritis(LN),to construct a diagnostic model for LN,and to evaluate and verify its diagnostic efficacy.Methods A total of 120 patients with LN admitted from January 2022 to January 2024 were selected as the observation group and divided into the training group(n=84)and the validation group(n=36)at a ratio of 7:3.Another 100 healthy individuals who underwent physical examination were selected as the control group.The expression levels of circRNA-0001445,circRNA-002059,hsa-circ-0007385 and hsa-circ-0000006 in urine specimens of patients in the training group and the control group were detected by gene sequencing.Multivariate Logistic regression analysis was used to construct a diagnostic model for LN based on the urinary circRNA expression level.The diagnostic value of individual indicators and combined predictive models were evaluated by receiver operating characteristic(ROC)curve analysis,and then the predictive efficacy of the model was verified by the validation group.Results The expression levels of circRNA-0001445,circRNA-002059,hsa-circ-0007385 and hsa-circ-0000006 in the urine of patients in the training group were all higher than those of the control group(P<0.01).Multivariate Logistic regression analysis found that The expression levels of circRNA-0001445(OR=1.094),circRNA-002059(OR=1.040),hsa-circ-0007385(OR=1.033),and hsa-circ-0000006(OR=1.130)in theurine were independent factor for the diagnosis of LN(P<0.01).ROC curve analysis showed that the areas under the curve of combined model constructed based on the circRNA expression level in the urine were 0.985 and 0.911 in the training group and the validation group,respectively,with sensitivities of 95.00%and 91.67%,and specificities of 99.00%and 89.00%,all of which were higher than the diagnostic efficacy of a single urinary circRNA expression level.Conclusion The diagnostic model of LN constructed based on the expression level of circRNA in the urine has a high diagnostic efficacy,which has been confirmed by internal tests and may provide strong support for clinicians in the early diagnosis of LN.

This paper explores the application and advancements of cross-cultural nursing concepts in the management of ICU patients. It identifies the core elements of humanistic care from a cross-cultural perspective, introduces relevant international research findings, and provides an in-depth analysis of existing challenges within the domestic healthcare context. Constructive suggestions are proposed to enhance the quality of life of ICU patients.

Objective:To study the efficacy and influencing factors of ursodeoxycholic acid (UDCA) in the treatment of cholesterol gallstone, so as to provide reference for the treatment of cholesterol gallstone by internal medicine.Methods:From March 1, 2017 to March 31, 2018, at outpatient department of gastroenterology of 9 Beijing medical centers including Peking University People′s Hospital, the Sixth Medical Center of PLA General Hospital, Beijing Huaxin Hospital, PLA Rocket Force Characteristic Medical Center, Peking University Aerospace Center Hospital, Beijing Youan Hospital of Capital Medical University and Beijing Tiantan Hospital of Capital Medical University, Beijing Tongren Hospital of Capital Medical University, and Beijing Shijitan Hospital of Capital Medical University, the data of patients with cholesterol gallstone treated by UDCA were collected. The inclusion criteria were that the largest diameter of stone was ≤10 mm and the stone was not detected under X-ray. The treatment plan was taking UDCA orally for 6 months at a dose of 10 mg·kg -1·d -1. The basic information of patients, the ultrasound examination results before treatment and 6 months after treatment, and scores of biliary abdominal pain and dyspepsia symptom were collected. Univariate and multivariate logistic regression were used to analyze the influencing factors of the efficacy in gallstrone dissolution by UDCA, and Wilcoxon signed rank test was used for statistical analysis. Results:A total of 215 patients were enrolled. The complete dissolution rate of gallstone was 19.5% (42/215) and partial dissolution rate was 50.7% (109/215), and the total effective rate was 70.2% (151/215). The complete dissolution rate of sandy stone was significantly higher than that of lumped stones (37.0%(17/46) vs. 14.8%(25/169); OR=3.377, 95% confidence interval (95% CI) 1.621 to 7.035, P=0.001). In lumped stones, the complete dissolution rate of the stones with diameter ≤5 mm was significantly higher than that of the stones with diameter >5 mm (37.5%(9/24) vs. 11.0%(16/145); OR=4.837, 95% CI 1.823 to 12.839, P=0.002). The complete dissolution rate of patients with higher body mass index ( OR=0.872, 95% CI 0.764 to 0.995, P=0.043) and longer disease course ( OR=0.942, 95% CI 0.912 to 0.973, P<0.001) was low. The results of multivariate logistic analysis indicated that long disease course of gallstone ( OR=0.940, 95% CI 0.908 to 0.974, P=0.001), rough gallbladder wall ( OR=0.438, 95% CI 0.200 to 0.962, P=0.040) and lumped stone ( OR=0.236, 95% CI 0.101 to 0.550, P=0.001) were independent risk factors of influencing the efficacy of stone dissolution by UDCA. As for lumped stones, the independent risk factors included long disease course of gallstone ( OR=0.926, 95% CI 0.877 to 0.978, P=0.006) and stone diameter >5 mm ( OR=0.142, 95% CI 0.043 to 0.470, P=0.001). After 6 months of UDCA treatment, score of biliary abdominal pain decreased from 0 (0 to 6) to 0 (0 to 0) and the score of dyspepsia symptom decreased from 1 (0 to 2) to 0 (0 to 0), and the differences between before treatment and after treatment were statistically significant ( Z=-8.50, and -9.13, both P<0.001). Conclusions:UDCA has a certain efficacy in cholesterol gallstone dissolution and can ease biliary abdominal pain and dyspepsia symptom. Long disease course of gallstone, rough gallbladder wall and stone diameter >5 mm are independent risk factors of poor efficacy in gallstone dissolution by UDCA.