Objective To comprehensively evaluate the current clinical application status of evidence regarding immunosuppressive medication compliance management in kidney transplant patients,construct review indicators,analyze the obstacles and promoting factors,and further formulate reform strategies.Methods Using the Joanna Briggs Institute evidence-based health care model as the theoretical framework,clinical nursing issues were identified,and a systematic search,evaluation,and summarization of 38 items of evidence were conducted.An evidence-based practice group was established;review indicators were constructed;review methods were clarified.Baseline reviews of systems,healthcare professionals,patients,and their families were conducted from November 1,2022,to January 31,2023.According to the review results,the obstacles and promoting factors in the process of evidence-based practice were analyzed,and corresponding strategies were formulated.Results A total of 23 review indicators were constructed.Among them,the accurate execution rate of 15 indicators was less than 60％,and the accurate execution rate of 4 indicators was 0.The main obstacles include a lack of systems and processes in departments,poor knowledge,attitude,and practice of medical staff,a lack of standardized risk assessment,and a lack of information support for out-of-hospital management.The primary promoting factors are strong organizational leadership,multidisciplinary team support,and high participation enthusiasm of recipients and their families.Corresponding reform strategies are formulated accordingly,including process and system improvement,continuous quality monitoring,enhanced standardized training and assessment,electronic health intervention for medication compliance,and involving patients and their families in the medication compliance management process.Conclusion There is a significant gap between the evidence on immunosuppressive medication compliance management in kidney transplant patients and its clinical practice.It is essential to assess the obstacles and facilitators scientifically and comprehensively in clinical situations,employ targeted reform strategies,facilitate the translation of evidence into clinical practice,and enhance the quality of nursing care.

Objective To analyze the application of a nursing outcome classification system in postoperative nursing of liver transplantation patients and its influence on the quality of clinical nursing records.Methods A total of 44 patients who underwent liver transplantation in a tertiary A general hospital in Zhejiang Province from March to August 2023 were selected by convenience sampling method.According to the North American Nursing Diagnosis Association International-Nursing Outcomes Classification linked scale of liver transplantation,nurses used the five-level classification method to score and review the liver transplantation patients on the day after surgery,3d after surgery,7d after surgery,14d after surgery,and on the day of discharge.The nursing outcome classification scores at 5 time points were statistically analyzed.The nursing records of 44 patients with liver transplantation from June to December 2022 were retrospectively collected by convenient sampling,and 44 nursing records before Nursing Outcomes Classification application and 44 nursing records after Nursing Outcomes Classification implementation were measured by Quality of Documentation of Nursing Diagnoses,Interventions and Outcomes.Results The Nursing Outcomes Classification scores of 15 nursing diagnoses were analyzed by single factor repeated measurement,and 9 of them showed continuous improvement and significant difference at 4 measurement time points(P＜0.05).After Nursing Outcomes Classification implementation,the total score of nursing record quality,nursing diagnosis and nursing outcome record quality scores were higher than those before implementation,with statistically significant differences(P＜0.05).Conclusion The nursing outcome classification system can be used to evaluate the postoperative health status and nursing effect of adult liver transplantation patients.It has high specialty specificity and can improve the quality of nursing records.

Objective:To investigate the condition of Kashin-Beck disease (KBD) in children aged 7 - 12 years in Inner Mongolia Autonomous Region.Methods:From 2016 to 2022, in accordance with the requirements of the annual "Central Subsidies for Local Public Health Special Funds for Kashin-Beck Disease Prevention and Control Project", surveillance for children aged 7 - 12 years was carried out in the villages of the disease affected areas in Inner Mongolia Autonomous Region, clinical examinations were conducted and hand X-ray films were taken.Results:From 2016 to 2022, a total of 275 919 children aged 7 - 12 years in Inner Mongolia Autonomous Region underwent clinical examinations, and 13 523 of them underwent X-ray examinations. In 2016, 1 clinical positive case and 22 X-ray positive cases were detected, with detection rates of 0.03% (1/3 722) and 0.59% (22/3 722), respectively. In 2017, no clinical positive case was detected; X-ray positive cases were detected in 23 cases, the detection rate was 0.57% (23/4 062). In 2018, no clinical positive case was detected; X-ray positive cases were detected in 2 cases, the detection rate was 0.05% (2/3 860). From 2019 to 2022, 70 670, 58 197, 69 536 and 65 872 children were clinically examined, and no clinical positive case was detected. In 2019, no X-rays were performed on children. From 2020 to 2022, 17, 4 and 1 858 children were examined by X-ray, and no X-ray positive case was detected.Conclusion:From 2016 to 2022, the clinical and X-ray positive detection rates of KBD in children aged 7 - 12 years in Inner Mongolia Autonomous Region are relatively low, and no clinical and X-ray positive cases are detected after 2020.

Objective:To construct a postoperative nursing plan for liver transplant recipients using the NANDA international, nursing outcomes classification, nursing intervention classification (NANDA-I-NOC-NIC) link (referred to as NNN-link) as the theoretical framework, so as to optimize the nursing process after liver transplantation and improve the quality of nursing.Methods:This study retrospectively collected nursing diagnoses with a postoperative usage rate of over 50% from 300 liver transplant recipients at Shulan (Hangzhou) Hospital from January 2019 to December 2021, and matched nursing outcomes and measures based on the NNN-link theory framework. After two rounds of Delphi expert consultation and group discussion, the entry content was rated, discussed, and modified to form the final version of the postoperative NNN-link for liver transplant recipients.Results:In two rounds of expert consultation, the recovery rates were 96.67% (29/30) and 100.00% (29/29) , respectively. The expert authority coefficients were 0.83 and 0.84, respectively. The Kendall harmony coefficients for the second round were 0.50, 0.38, 0.35. The final postoperative NNN-link for liver transplant recipients included 15 nursing diagnoses, 42 nursing outcomes, and 106 nursing measures.Conclusions:The process of constructing the postoperative NNN-link for liver transplant recipients is scientific and reasonable, and the entries are highly specialized, which can provide reference for clinical nursing after liver transplantation.

Objective:To investigate the condition of Kashin-Beck disease (KBD) in children aged 7 - 12 years in Inner Mongolia Autonomous Region.Methods:From 2016 to 2022, in accordance with the requirements of the annual "Central Subsidies for Local Public Health Special Funds for Kashin-Beck Disease Prevention and Control Project", surveillance for children aged 7 - 12 years was carried out in the villages of the disease affected areas in Inner Mongolia Autonomous Region, clinical examinations were conducted and hand X-ray films were taken.Results:From 2016 to 2022, a total of 275 919 children aged 7 - 12 years in Inner Mongolia Autonomous Region underwent clinical examinations, and 13 523 of them underwent X-ray examinations. In 2016, 1 clinical positive case and 22 X-ray positive cases were detected, with detection rates of 0.03% (1/3 722) and 0.59% (22/3 722), respectively. In 2017, no clinical positive case was detected; X-ray positive cases were detected in 23 cases, the detection rate was 0.57% (23/4 062). In 2018, no clinical positive case was detected; X-ray positive cases were detected in 2 cases, the detection rate was 0.05% (2/3 860). From 2019 to 2022, 70 670, 58 197, 69 536 and 65 872 children were clinically examined, and no clinical positive case was detected. In 2019, no X-rays were performed on children. From 2020 to 2022, 17, 4 and 1 858 children were examined by X-ray, and no X-ray positive case was detected.Conclusion:From 2016 to 2022, the clinical and X-ray positive detection rates of KBD in children aged 7 - 12 years in Inner Mongolia Autonomous Region are relatively low, and no clinical and X-ray positive cases are detected after 2020.

Objective:To construct the standardized training curriculum system for head nurse leadership based on five forces model.Methods:The first draft of the standardized training curriculum system for head nurse leadership was determined through literature review and semi-structured interview. From April to June 2022, 18 clinical experts from 8 provinces/cities across the country were selected for Delphi expert consultation to form a standardized training curriculum system for head nurse leadership.Results:In both rounds of consultation, 18 questionnaires were collected, and the effective response rate were 100.0%. The expert authority coefficients were 0.914 and 0.892, respectively. Based on the results of the expert consultation, the training system content was revised and improved, and all indicators met statistical standards, with expert opinions tending to be consistent. Finally, a standardized training curriculum system for head nurse leadership was formed consisting of 5 training themes, 18 course names and 67 course knowledge points.Conclusions:The standardized training curriculum system for head nurse leadership is scientific and systematic, which can provide reference for the leadership training of head nurses.

Objective:To systematically evaluate the qualitative studies on the psychological experience of living donors after liver transplantation, analyzing the psychological experience of living donors after liver transplantation, so as to provide a basis for formulating intervention measures to meet their inner needs.Methods:Qualitative studies on postoperative psychological experience and life experience of living liver transplant donors were searched by computer on PubMed, Web of Science, Embase, Cochrane Library, EBSCO, CNKI, Wanfang Database, China Biology Medicine disc, VIP and other databases. The search period was from the establishment of the database to November 30, 2022. The quality of the included studies was evaluated using the Joanna Briggs Institute (JBI) Evidence-Based HealthCare Quality Evaluation Criteria (2016) , and the results were integrated using a pooled integration approach.Results:A total of 10 articles were included, 29 main results were extracted and summarized into 6 new categories. The 3 integrated results were negative psychological experience of living liver transplant donors after surgery, positive psychological experience of living liver transplant donors after surgery, and psychological support needs of living liver transplant donors after surgery.Conclusions:Nurses should pay attention to the negative psychological experience of living donors after liver transplantation, strengthen their positive psychological experience, help them get more family and social support after liver transplantation and meet their psychological and physiological support needs.

Objective:To investigate the current status and evolutionary trajectory of research on the information management of pressure injury care in hospitals of China.Methods:The bibliometric method was used for analysis. Using the China National Knowledge Infrastructure (CNKI) database as the data source, the literature on information management of pressure injury care in hospitals was retrieved, covering the time period from the establishment of the CNKI database to July 31, 2022, and various types of literature such as guidelines, expert consensus, case studies, reviews, and survey reports, etc. Visualized analysis of clustering and co-occurrence on the keywords, authors, publishing institutions, and number of journals of the included literature were performed using CiteSpace 6.1.R2 software.Results:A total of 378 articles were retrieved, and 323 articles were included after collation. The number of literatures related to nursing information management of pressure injury in hospitals showed a significantly upward trend since 2012. Ten core authors published two or more articles as the first author. There were eight groups of co-authors with ≥3 people. Furthermore, 306 institutions contributed articles related to the information management of pressure injury care, with Peking University Shenzhen Hospital as the institution publishing the most articles (4 articles). Cooperation between institutions was relatively decentralized. The 323 included literature were sourced from 142 journals, six of which had published ten or more articles. A comprehensive co-occurrence analysis of 282 Chinese keywords was performed, with the top three keywords in terms of frequency being pressure ulcer, nursing management, and nursing. A total of 13 clusters were formed, and the persistent clusters were #1 quality of care, #2 nursing, and #6 surgical patients. The top 8 emergent keywords of emergence intensity in the database included early warning intervention, early warning management, early warning mechanism, information system, nursing safety, adverse events, operating room, and quality of care. In the past three years (2020-2022), the top two emergent keywords in terms of emergy intensity included operating room and quality of care. The key word with the longest duration (2005-2012) and the highest intensity was early warning intervention.Conclusions:The research hotspots on information management of pressure injury care in domestic hospitals have been formed. Early studies focus on the intervention after the pressure injury developed, while later studies focus more on the overall management of pressure injuries. Collaboration between institutions within research areas and correlations between studies are still lacking.

Objective:To analyze the difference of clinical characteristics and outcomes of infants with moderate and severe pediatric acute respiratory distress syndrome(PARDS)diagnosed according to baseline oxygenation index(OI) in pediatric intensive care unit(PICU).Methods:Second analysis of the data collected from the "Efficacy of pulmonary surfactant (PS) in the treatment of children with moderate and severe ARDS" program.Retrospectively compare of the differences in clinical data such as general condition, underlying diseases, OI, mechanical ventilation, PS administration and outcomes among infants with moderate and severe PARDS divided by baseline OI who admitted to PICUs at 14 participating tertiary hospitals from 2016 to December 2021.Results:Among the 101 cases, 55 cases (54.5%) were moderate and 46 cases (45.5%) were severe PARDS.The proportion of male in the severe group (50.0% vs.72.7%, P=0.019) and the pediatric critical illness score(PCIS)[72 (68, 78) vs.76 (70, 80), P=0.019] were significantly lower than those in the moderate group, while there was no significant difference regarding age, body weight, etiology of PARDS and underlying diseases.The utilization rate of high-frequency ventilator in the severe group was significantly higher than that in the moderate group (34.8% vs.10.9%, P=0.004), but there was no significant difference in PS use, fluid load and pulmonary complications.The 24 h OI improvement (0.26±0.33 vs.0.04±0.34, P=0.001) and the 72 h OI improvement[0.34 (-0.04, 0.62) vs.0.15 (-0.14, 0.42), P=0.029)]in the severe group were significantly better than those in the moderate group, but there was no significant difference regarding mortality, length of hospital stay and intubation duration after diagnosis of PARDS between the two groups. Conclusion:In moderate and severe(divided by baseline OI) PARDS infants with invasive mechanical ventilation, children in severe group have better oxygenation improvement in the early stage after PARDS identified and are more likely to receive high frequency ventilation compared to those in moderate group.Baseline OI can not sensitively distinguish the outcomes and is not an ideal index for PARDS grading of this kind of patient.

Idiopathic pulmonary fibrosis (IPF) is a chronic progressive lung disease characterized by progressive lung fibrogenesis and histological features of usual interstitial pneumonia. IPF has a poor prognosis and presents a spectrum of disease courses ranging from slow evolving disease to rapid deterioration; thus, a differential diagnosis remains challenging. Several biomarkers have been identified to achieve a differential diagnosis; however, comprehensive reviews are lacking. This review summarizes over 100 biomarkers which can be divided into six categories according to their functions: differentially expressed biomarkers in the IPF compared to healthy controls; biomarkers distinguishing IPF from other types of interstitial lung disease; biomarkers differentiating acute exacerbation of IPF from stable disease; biomarkers predicting disease progression; biomarkers related to disease severity; and biomarkers related to treatment. Specimen used for the diagnosis of IPF included serum, bronchoalveolar lavage fluid, lung tissue, and sputum. IPF-specific biomarkers are of great clinical value for the differential diagnosis of IPF. Currently, the physiological measurements used to evaluate the occurrence of acute exacerbation, disease progression, and disease severity have limitations. Combining physiological measurements with biomarkers may increase the accuracy and sensitivity of diagnosis and disease evaluation of IPF. Most biomarkers described in this review are not routinely used in clinical practice. Future large-scale multicenter studies are required to design and validate suitable biomarker panels that have diagnostic utility for IPF.
Humans ; Idiopathic Pulmonary Fibrosis/diagnosis* ; Biomarkers ; Lung Diseases, Interstitial ; Lung ; Bronchoalveolar Lavage Fluid ; Disease Progression ; Prognosis