Objective To explore the preventive effect of multidisciplinary collaborative evidence-based nursing on dysphagia in patients with orotracheal intubation in intensive care unit(ICU)after extubation.Methods A retrospective analysis was performed on 200 patients with orotracheal intubation in ICU who were admitted to Dongguan Traditional Chinese Medicine Hospital between January and December 2023.Of them,96 patients who were admitted to our hospital between January and May 2023 received routine nursing(routine group),104 patients who were admitted to our hospital between June and December 2023 received multidisciplinary collaborative evidence-based nursing(evidence-based group).The incidence of dysphagia after extubation,water swallowing test result,swallowing function measured with M.D.Anderson dysphagia inventory(MDADI),psychological state assessed by connor-davidson resilience scale(CD-RISC),quality of life assessed by swallowing quality-of-life questionnaire(SWAL-QOL),and the incidence of dysphagia complications(aspiration,aspiration pneumonia,and malnutrition)were compared between the two groups.Results The incidence of dysphagia after extubation and the water swallowing test class in the evidence-based group were lower than those in the routine group(both P<0.05).The total score of MDADI and CD-RISC scores in the evidence-based group were significantly higher than those in the routine group(P<0.05),while the SWAL-QOL scores were lower(P<0.05).The incidence of complications in the evidence-based group was significantly lower than that in the routine group(P<0.05).Conclusion Multidisciplinary collaborative evidence-based nursing can effectively reduce the incidence of dysphagia in patients with orotracheal intubation in ICU after extubation,improve swallowing function,psychological state and quality of life,and reduce the incidence of complications.

Objective:To explore the effect of vitamin D supplement on chronic musculoskeletal pain (CMP) in patients with ankylosing spondylitis (AS) through a cohort study and provide evidence for optimizing vitamin D supplement strategies in AS management.Methods:Based on the large-scale prospective cohort of the UK Biobank, a total of 1 497 middle-aged and older patients diagnosed with AS were included. Patients were categorized into three groups according to their baseline vitamin supplements usage: non-vitamin supplement group ( n=978), vitamin D supplement group ( n=65), and other vitamin supplements group ( n=454). The occurrence of CMP was obtained by baseline pain survey and follow-up data from 2019—2020 and 2022—2023. A generalized linear mixed model (GLMM) was used to analyze the association between vitamin D supplement and CMP occurrence, with odds ratio ( OR) and its 95% confidence intervals ( CI) calculated. To verify robustness of the study findings, propensity score matching was employed to match participants in the vitamin D supplementation group with those in the non-vitamin supplement group and the other vitamin supplements group for sensitivity analysis. Results:After adjusting for confounding factors such as demographic characteristics, lifestyle, and co-morbidities, GLMM analysis did not find significant association between vitamin D supplement and the risk of CMP occurrence in AS patients [ OR(95% CI)=0.85(0.48, 1.48), P=0.555]. However, GLMM analysis indicated that male AS patients had a lower likelihood of developing CMP compared to female patients [ OR(95% CI)=0.69(0.56, 0.86), P<0.001]. Additionally, current smoking [ OR(95% CI)=1.46(1.06, 2.03), P=0.022] and poorer overall health status-categorized as general [ OR(95% CI)=2.32(1.85, 2.90)] or poor [ OR(95% CI)=2.31(1.68, 3.18), P<0.001] were associated with an increased risk of CMP occurrence. In the sensitivity analysis, no significant association was observed between vitamin D supplement and CMP. Conclusion:Vitamin D supplement does not reduce the risk of CMP occurrence in middle-aged and old AS patients. However, female, smoking, and poor overall health status are identified as risk factors for CMP in AS patients. Future research should focus on large-scale real-world studies, particularly in younger AS populations, to further investigate the relationship between vitamin D supplement and CMP, thereby providing more targeted intervention strategies.

Objective:To explore the effect of vitamin D supplement on chronic musculoskeletal pain (CMP) in patients with ankylosing spondylitis (AS) through a cohort study and provide evidence for optimizing vitamin D supplement strategies in AS management.Methods:Based on the large-scale prospective cohort of the UK Biobank, a total of 1 497 middle-aged and older patients diagnosed with AS were included. Patients were categorized into three groups according to their baseline vitamin supplements usage: non-vitamin supplement group ( n=978), vitamin D supplement group ( n=65), and other vitamin supplements group ( n=454). The occurrence of CMP was obtained by baseline pain survey and follow-up data from 2019—2020 and 2022—2023. A generalized linear mixed model (GLMM) was used to analyze the association between vitamin D supplement and CMP occurrence, with odds ratio ( OR) and its 95% confidence intervals ( CI) calculated. To verify robustness of the study findings, propensity score matching was employed to match participants in the vitamin D supplementation group with those in the non-vitamin supplement group and the other vitamin supplements group for sensitivity analysis. Results:After adjusting for confounding factors such as demographic characteristics, lifestyle, and co-morbidities, GLMM analysis did not find significant association between vitamin D supplement and the risk of CMP occurrence in AS patients [ OR(95% CI)=0.85(0.48, 1.48), P=0.555]. However, GLMM analysis indicated that male AS patients had a lower likelihood of developing CMP compared to female patients [ OR(95% CI)=0.69(0.56, 0.86), P<0.001]. Additionally, current smoking [ OR(95% CI)=1.46(1.06, 2.03), P=0.022] and poorer overall health status-categorized as general [ OR(95% CI)=2.32(1.85, 2.90)] or poor [ OR(95% CI)=2.31(1.68, 3.18), P<0.001] were associated with an increased risk of CMP occurrence. In the sensitivity analysis, no significant association was observed between vitamin D supplement and CMP. Conclusion:Vitamin D supplement does not reduce the risk of CMP occurrence in middle-aged and old AS patients. However, female, smoking, and poor overall health status are identified as risk factors for CMP in AS patients. Future research should focus on large-scale real-world studies, particularly in younger AS populations, to further investigate the relationship between vitamin D supplement and CMP, thereby providing more targeted intervention strategies.

Objective To compare the clinical effects between laparoscopic radical resection combined with radiofrequency ablation (RFA) and open radical resection for colorectal liver metastases.Methods The retrospective cohort study was conducted.The clinicopathological data of 120 colorectal liver metastases patients who were admitted to the Mengchao Hepatobiliary Hospital of Fujian Medical University (80 patients) and the Third Mfiliated Hospital of Chongqing Medical University (40 patients) between September 2012 and April 2017 were collected.Sixty patients undergoing laparoscopic radical resection of colorectal cancer combined with RFA of liver metastases were allocated into the laparoscopy with RFA group,and 60 undergoing open radical resection of colorectal liver metastases were allocated into the open group.Observation indicators:(1) surgical and postoperative situations;(2) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival up to May 2017.Measurement data with normal distribution were represented as x±s,and comparisons between groups were analyzed using independent-sample t test.Measurement data with skewed distribution were described as M (range).Comparisons of count data were analyzed using chi-square test or Fisher exact probability.The repeated measures data were analyzed using the repeated measures ANOVA.The survival curve and rate were respectively drawn and calculated by the Kaplan-Meier method,and the Log-rank test was used for survival analysis.Results (1) Surgical and postoperative situations:① All the patients underwent successful surgery,without conversion to open surgery in the laparoscopy with RFA group.Operation time,volume of intraoperative blood loss,cases with overall complications,death,abdominal pain,nausea and vomiting,liver dysfunction,pleural effusion,non-calculus cholecystitis and peptic ulcer and duration of postoperative hospital stay were respectively (135±34)minutes,(451±197)mL,31,0,18,6,6,4,3,2,(13±4)days in the laparoscopy with RFA group and (165±49)minutes,(794±204)mL,42,1,15,9,10,11,5,5,(19±4)days in the open group,with statistically significant differences in operation time,volume of intraoperative blood loss,cases with overall complications and duration of postoperative hospital stay between groups (t =3.983,9.394,x2 =4.232,t =9.148,P＜0.05),and no statistically significant differences in cases with death,abdominal pain,nausea and vomiting,liver dysfunction,pleural effusion,non-calculus cholecystitis and peptic ulcer between groups x2 =0.376,0.686,1.154,3.733,0.134,0.607,P＞0.05).() Levels of alanine aminotransferase (ALT),total bilirubin (TBil) and prothronbin time (PT) before operation,at day 1 and 3 postoperatively were respectively (70±9)U/L,(399±36)U/L,(231±19) U/L,(21±3) μmol/L,(26±3) μmol/L,(23±5) μmol/L,(17.3±2.4) seconds,(20.2-±4.4) seconds,(18.9±2.8) seconds in the laparoscopy with RFA group and (68± 8) U/L,(412±39)U/L,(253±22)U/L,(21±4)μmol/L,(28±4)μmol/L,(27±8)μmol/L,(16.6±3.0)seconds,(22.1±5.2) seconds,(20.1± 4.4)seconds in the open group,with statistically significant differences in the levels of ALT,TBil and PT before operation,at day 1 and 3 postoperatively between groups (F=16.727,13.115,4.194,P＜0.05).(2) Follow-up and survival situations:120 patients were followed up for 7-24 months,with a median time of 20 months.The postoperative 1-and 2-year tumor-free survival rates,1-and 2-year overall survival rates were respectively 23.3％,11.9％,85.0％,40.0％ in the laparoscopy with RFA group and 20.0％,12.8％,83.3％,38.3％ in the open group,with no statistically significant difference in above indicators between groups (x2 =0.145,0.069,0.012,0.196,P＞0.05).Further analysis showed that postoperative 2-year overall survival rate of patients with 1,2,3 and ＞3 liver metastasis lesions were respectively 53.3％,38.2％,40.0％,16.7％ in the laparoscopy with RFA group and 50.0％,35.7％,40.0％,15.4％ in the open group,with a statistically significant difference in 2-year survival rate of patients with different liver metastasis lesions in the laparoscopy with RFA group (x2 =20.949,P＜0.05) and in the open group (x2 ＝ 21.349,P＜0.05).Conclusion There are some advantages of fewer traumas,less complications,faster postoperative recovery and minimally invasive in laparoscopic radical resection combined with RFA for colorectal liver metastases,meanwhile,less liver metastasis lesions and better prognosis are found.