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 investigate the relationship between the cardiac function parameters of ultrasound monitoring and the expression level of serum sentrin/SUMO-specific protease1 (SENP-1)/hypoxia-inducible factor 1 alpha (HIF-1α) pathway,and the predictive value of them on curative effect on patients with obstructive sleep apnea hypopnea syndrome (OSAHS) complicated with cardiovascular and cerebrovascular diseases. Methods:A total of 100 patients with OSAHS complicated with cardiovascular and cerebrovascular diseases,who admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2021 to June 2023,were selected as the study objects,and all of them were treated with continuous positive airway pressure (CPAP). According to the treatment effect,they were divided into effective group (n=65) and ineffective group (n=35). The ultrasound was adopted to measure the parameters of cardiac function,and the Enzyme linked immunosorbent assay (ELISA) was used to measure expression levels of SENP-1/HIF-1α pathway. The parameters of cardiac function and the expression levels of SENP-1/HIF-1α pathway of two groups between before and after treatment were compared. The Pearman analysis was adopted to analyze the correlation between the parameters of cardiac function and the levels of SENP-1/HIF-1α pathway before treatment. The receiver operating characteristic (ROC) curve was drawn to assess the predictive efficacy of single pre-treatment parameters of cardiac function,single SENP-1/HIF-1α pathway and the combined detection of them on the curative effect of patients with OSAHS complicated with cardiovascular and cerebrovascular diseases. Results:The left ventricular end-diastolic diameter (LVEDD),left ventricular end-systolic diameter (LVESD) and the index of myocardial work (Tei) of effective group after treatment were significantly lower than those before treatment,and those indicators of effective group were significantly lower than them of ineffective group (t=4.257,3.400,5.454,P<0.05),respectively. The LVEF,LVFS and ratio of early peak velocity (E) of blood flow to late peak velocity (A) of blood flow (E/A) of mitral valve in the effective group after treatment were significantly higher than those before treatment,and these indicators of effective group were significantly higher than those of ineffective group (t=4.517,2.280,4.952,P<0.05),respectively. Serum SENP-1 and HIF-1α levels in the effective group after treatment were significantly lower than those before treatment,and these indicators of effective group were significantly lower than those of ineffective group (t=2.648,4.520,P<0.05),respectively. Pearman correlation analysis showed that LVEDD,LVESD and Tei index were positively correlated with SENP-1 (r=0.523,0.572,0.513,P<0.05),and were negatively correlated with SENP-1/HIF-1α(r=-0.508,-0.411,-0.479,P<0.05),respectively. The LVEF,LVFS and E/A were positively correlated with HIF-1α (r=0.453,0.511,0.426,P<0.05),and LVEF,LVFS and E/A were negatively correlated with SENP-1/HIF-1α (r=-0.489,-0.479,-0.421,P<0.05),respectively. The area under curve (AUC) value of the combined detection of the parameters of cardiac function and serum SENP-1/HIF-1α pathway in predicting the curative effect of patients with OSAHS complicated with cardiovascular and cerebrovascular diseases was 0.909 (95％CI:0.843～0.975). Conclusion:The combined detection of the parameters of cardiac function of ultrasonic determination and SENP-1/HIF-1α pathway has higher predictive value for the curative effect of patients with OSAHS complicated with cardiovascular and cerebrovascular diseases.

Objective:To investigate the relationship between the cardiac function parameters of ultrasound monitoring and the expression level of serum sentrin/SUMO-specific protease1 (SENP-1)/hypoxia-inducible factor 1 alpha (HIF-1α) pathway,and the predictive value of them on curative effect on patients with obstructive sleep apnea hypopnea syndrome (OSAHS) complicated with cardiovascular and cerebrovascular diseases. Methods:A total of 100 patients with OSAHS complicated with cardiovascular and cerebrovascular diseases,who admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2021 to June 2023,were selected as the study objects,and all of them were treated with continuous positive airway pressure (CPAP). According to the treatment effect,they were divided into effective group (n=65) and ineffective group (n=35). The ultrasound was adopted to measure the parameters of cardiac function,and the Enzyme linked immunosorbent assay (ELISA) was used to measure expression levels of SENP-1/HIF-1α pathway. The parameters of cardiac function and the expression levels of SENP-1/HIF-1α pathway of two groups between before and after treatment were compared. The Pearman analysis was adopted to analyze the correlation between the parameters of cardiac function and the levels of SENP-1/HIF-1α pathway before treatment. The receiver operating characteristic (ROC) curve was drawn to assess the predictive efficacy of single pre-treatment parameters of cardiac function,single SENP-1/HIF-1α pathway and the combined detection of them on the curative effect of patients with OSAHS complicated with cardiovascular and cerebrovascular diseases. Results:The left ventricular end-diastolic diameter (LVEDD),left ventricular end-systolic diameter (LVESD) and the index of myocardial work (Tei) of effective group after treatment were significantly lower than those before treatment,and those indicators of effective group were significantly lower than them of ineffective group (t=4.257,3.400,5.454,P<0.05),respectively. The LVEF,LVFS and ratio of early peak velocity (E) of blood flow to late peak velocity (A) of blood flow (E/A) of mitral valve in the effective group after treatment were significantly higher than those before treatment,and these indicators of effective group were significantly higher than those of ineffective group (t=4.517,2.280,4.952,P<0.05),respectively. Serum SENP-1 and HIF-1α levels in the effective group after treatment were significantly lower than those before treatment,and these indicators of effective group were significantly lower than those of ineffective group (t=2.648,4.520,P<0.05),respectively. Pearman correlation analysis showed that LVEDD,LVESD and Tei index were positively correlated with SENP-1 (r=0.523,0.572,0.513,P<0.05),and were negatively correlated with SENP-1/HIF-1α(r=-0.508,-0.411,-0.479,P<0.05),respectively. The LVEF,LVFS and E/A were positively correlated with HIF-1α (r=0.453,0.511,0.426,P<0.05),and LVEF,LVFS and E/A were negatively correlated with SENP-1/HIF-1α (r=-0.489,-0.479,-0.421,P<0.05),respectively. The area under curve (AUC) value of the combined detection of the parameters of cardiac function and serum SENP-1/HIF-1α pathway in predicting the curative effect of patients with OSAHS complicated with cardiovascular and cerebrovascular diseases was 0.909 (95％CI:0.843～0.975). Conclusion:The combined detection of the parameters of cardiac function of ultrasonic determination and SENP-1/HIF-1α pathway has higher predictive value for the curative effect of patients with OSAHS complicated with cardiovascular and cerebrovascular diseases.

Objective To observe the impatcts of health care follow-up after chronic heart failture on cardiovascular events and qualigy of life.Methods One hundred and sixty-six patients who were confirmed to have chronic heart failture in our hospital during February 2007 and December 2008 were enrolled in this investigation.The patients were then assigned to the health management group (n=65) or the non-health management group (n=101) and followed up for 5 years.All-cause mortality,readmission for heart failture and quality of life (SF-36 score) were evaluated.Results There was no significant difference of all-cause mortalitv between the two groups (health management group:12.30％ (8/65); non-health management group:14.85％ (15/101; x2=0.22,P＞0.05),although a statistically significant difference of readmission rate was found between the two groups (health management group:12.30％ (9/65); non-health management group:35.64％ (36/101; x2=9.51,P＜0.05).In health management group,the scores of SF-36 were significantly increased at 3 (114.11 ±2.76) or 5 years (116.07± 15.43) when compared with baseline (91.37 ± 2.62) (x2 =102.39,P＜0.05).For the non-health management group,the scores of SF-36 were significantly decreased from 92.65±3.65 at baseline to 90.09±5.12 at 3 years or 89.08±5.71 at 5 years (x2=102.39,P＜0.05).Conclusion Health care follow-up after chronic heart failture may not decrease all-cause mortality,although can decrease readmission rate and improve quality of life of the patients.