With the increasing incidence of chronic diseases,the research is conducted to actively explore out of hospital management models for chronic disease patients globally.Among them,virtual ward is a management model based on multidisciplinary team collaboration to provide professional medical and nursing services for unplanned hospitalization high-risk population.This model not only facilitates the transition of patients from inpatient settings to home environments,improving disease prognosis and reducing hospitalization risk,but also alleviates the bed burden on large hospitals.This article provides a review of the concept,development,construction of the operational system,and patient management processes of virtual wards,and offers insights and suggestions to provide references for the optimization and development of out of hospital management models for chronic disease patients in China.

With the increasing incidence of chronic diseases,the research is conducted to actively explore out of hospital management models for chronic disease patients globally.Among them,virtual ward is a management model based on multidisciplinary team collaboration to provide professional medical and nursing services for unplanned hospitalization high-risk population.This model not only facilitates the transition of patients from inpatient settings to home environments,improving disease prognosis and reducing hospitalization risk,but also alleviates the bed burden on large hospitals.This article provides a review of the concept,development,construction of the operational system,and patient management processes of virtual wards,and offers insights and suggestions to provide references for the optimization and development of out of hospital management models for chronic disease patients in China.

Since the National Health Commission launched the pilot work of " Internet+ nursing service" in 2019, medical institutions at all levels in China keep innovating their nursing service models to provide targeted high-quality care for discharged patients or special groups suffering from diseases and poor mobility. In April 2021, a tertiary hospital in Qingdao carried out the " Internet+ " whole course management practice with specialized nurses as the main service subjects, which center on discharged patients as the main service objects. By estabusing a management team and the construction of " Internet+ " information exchange platform, the hospital implemented the whole course of disease management process including patients′ pre-hospital management, in-hospital estimate, and post-hospital follow-up rehabilitation, to provide specialized nursing services such as PICC dressing change care, stoma care, and mother and infant care for patients at home. By February 2022, the " Internet+ " whole course management service had expanded to 50 kilometers away from hospital, with a total of 1 181 specialized nursing services. This management highlighted the characteristics of specialized nursing services in tertiary hospitals, accurately matched the needs of patients, reflected the concept of holistic care, and provided references for the rapid promotion of the development of " Internet+ nursing service" in China.

Objective:To investigate the effects of dexmetomide intrathecal injection on the behavior and the spinal cord glial cells of rats with phantom limb pain.Methods:Eighteen healthy and clean adult male SD rats were randomly divided into three groups ( n=6): sham operation group, control group, and DEX group. The control group and the DEX group were used to establish the model of phantom limb pain by chronic constriction injury of the sciatica (CCI); and the sham operation group was treated with sham operations. One week after the establishment of the model, a single intrathecal injection was carried out. The sham operation group was treated with normal saline, and the control group was treated with DEX at a dose of 30 μg/kg. At the time points before the intrathecal injection (T1), and 30 min (T2), 12 h (T3), 2 d (T4), and 1 week (T5) after the intrathecal injection, the behavior, the bradykinin (BK) and histamine (HIS) contents in the blood of the rats at each time point were observed and recorded. One week later, three rats in each group were randomly selected according to random number table method and killed; and the changes of the glial cell activation in the spinal cords of the rats in each group were observed through immunohistochemical staining. Results:Compared with the sham operation group, the total moving distances were significantly reduced in the control group and the DEX group at T1 ( P<0.05). In the DEX group, the total moving distances of the rats at T2, T3, T4 and T5 were significantly higher than those at T1 ( P<0.05). The total moving distances and the counts of crossed squares in the DEX group increased with time. The time of movement at T2 and T5 were significantly higher than those of T1 ( P<0.05). Compared with T1, the BK and HIS values in the control group showed an increasing trend with time; and the BK and HIS values in the DEX group showed a decreasing trend. Compared with the sham operation group, the astrocytes and microglia increased significantly in the control group ( P<0.05). Compared with the control group, the count of astrocytes in the DEX group decreased significantly ( P<0.05). Conclusion:Dexmetomide intrathecal injection can improve the motor behavior of rats with phantom limb pain, inhibit the pain-causing factor and inflammatory factors, and decrease the activation of glial cells in the spinal cord to protect the nerves. Hence it is a new idea for the treatment of phantom limb pain.

Objective:To investigate the effects of dexmetomide intrathecal injection on the behavior and the spinal cord glial cells of rats with phantom limb pain.Methods:Eighteen healthy and clean adult male SD rats were randomly divided into three groups ( n=6): sham operation group, control group, and DEX group. The control group and the DEX group were used to establish the model of phantom limb pain by chronic constriction injury of the sciatica (CCI); and the sham operation group was treated with sham operations. One week after the establishment of the model, a single intrathecal injection was carried out. The sham operation group was treated with normal saline, and the control group was treated with DEX at a dose of 30 μg/kg. At the time points before the intrathecal injection (T1), and 30 min (T2), 12 h (T3), 2 d (T4), and 1 week (T5) after the intrathecal injection, the behavior, the bradykinin (BK) and histamine (HIS) contents in the blood of the rats at each time point were observed and recorded. One week later, three rats in each group were randomly selected according to random number table method and killed; and the changes of the glial cell activation in the spinal cords of the rats in each group were observed through immunohistochemical staining. Results:Compared with the sham operation group, the total moving distances were significantly reduced in the control group and the DEX group at T1 ( P<0.05). In the DEX group, the total moving distances of the rats at T2, T3, T4 and T5 were significantly higher than those at T1 ( P<0.05). The total moving distances and the counts of crossed squares in the DEX group increased with time. The time of movement at T2 and T5 were significantly higher than those of T1 ( P<0.05). Compared with T1, the BK and HIS values in the control group showed an increasing trend with time; and the BK and HIS values in the DEX group showed a decreasing trend. Compared with the sham operation group, the astrocytes and microglia increased significantly in the control group ( P<0.05). Compared with the control group, the count of astrocytes in the DEX group decreased significantly ( P<0.05). Conclusion:Dexmetomide intrathecal injection can improve the motor behavior of rats with phantom limb pain, inhibit the pain-causing factor and inflammatory factors, and decrease the activation of glial cells in the spinal cord to protect the nerves. Hence it is a new idea for the treatment of phantom limb pain.

Objective To analyze the effects of nursing intervention on the prevention of infection in the operation room of a certain Nansha reef hospital.Methods One hundred and seventy-six outpatients who received surgery from March 2016 to November 2017 in a certain Nansha reef hospital were randomly divided into the intervention group and the control group,each group consisting of 88 patients.The intervention group received interventions in environmental temperature and humidity control,patient education and other nursing measures,while the control group received routine nursing measures.Then,rates of infection and nursing satisfaction were compared between the patients of the 2 groups.Results There was only ease of infection in the intervention group (1.1％),which was significantly lower than 7 cases in the control group (8.0％).The rate of nursing satisfaction in the intervention group (94.3％) was significantly higher than that of the control group (69.3％),and statistical significance could be seen when comparisons were made between them (P ＜ 0.05).Conclusions Nursing intervention could effectively reduce the rate of infection in the outpatients undergoing surgery in the special climate environment in the Nansha reef hospital,and improve nursing satisfaction.For this reason,it is worth further clinical promotion.

Objective To analyze the effects of nursing intervention on the prevention of infection in the operation room of a certain Nansha reef hospital.Methods One hundred and seventy-six outpatients who received surgery from March 2016 to November 2017 in a certain Nansha reef hospital were randomly divided into the intervention group and the control group,each group consisting of 88 patients.The intervention group received interventions in environmental temperature and humidity control,patient education and other nursing measures,while the control group received routine nursing measures.Then,rates of infection and nursing satisfaction were compared between the patients of the 2 groups.Results There was only ease of infection in the intervention group (1.1％),which was significantly lower than 7 cases in the control group (8.0％).The rate of nursing satisfaction in the intervention group (94.3％) was significantly higher than that of the control group (69.3％),and statistical significance could be seen when comparisons were made between them (P ＜ 0.05).Conclusions Nursing intervention could effectively reduce the rate of infection in the outpatients undergoing surgery in the special climate environment in the Nansha reef hospital,and improve nursing satisfaction.For this reason,it is worth further clinical promotion.