Objective:To explore the "Internet + nursing service" model based on the nurse-patient safety needs, and provide reference for development of "Internet + nursing service".Methods:The First Affiliated Hospital of Sun Yatsen University established a "Internet+ nursing service" management team in December 2019, developed an information platform, formulated and implemented a specific plan of the "Internet+ nursing service" model, including service objects, service projects and service modes. After the smooth operation of this model, the statistics of the nursing service projects and service times that had been carried out from September 2020 to March 2021, as well as the satisfaction of 21 patients who received nursing services would be counted.Results:From September 2020 to March 2021, 21 patients were provided with 55 on-site nursing services, and 151 operations in 16 projects were completed. No nursing-related adverse events occurred. The patients gave all five-star evaluations to the door-to-door service, the satisfaction score was 5 points, and the overall evaluation was 99.88 points.Conclusions:The pilot work of "Internet + nursing service" based on the nurse-patient safety needs has met the care needs of discharged patients and the safety needs of door-to-door services, guarantee the safety of nurses' door-to-door service effectively. And it provides reference for the development and improvement of "Internet + nursing service" related safety work in tertiary A-level hospitals.

Objective To systematically evaluate the medication experience of patients with chronic multimorbidities and to provide a reference for developing precise intervention programs to improve the medication experience of patients with chronic multimorbidities.Methods PubMed,Cochrane Library,Web of Science,Embase,CINAHL,PsycINFO,CNKI,Wanfang database,VIP database,and Chinese biomedical literature database were searched from the year of database establishment to October 2022,and qualitative studies on medication experiences of patients with chronic multimorbidities were retrieved.The Joanna Briggs Institute Critical Appraisal Tool for qualitative research(2016)in Australia was used to evaluate quality of the studies.A meta-synthesis method was used to integrate the results.Results A total of 11 articles were included,and 56 research results were extracted and integrated into 12 new categories,which were summarized into 4 integrated results:poor sensory experience of drugs,negative emotional and related experiences,reflective and behavioral experiences,and multi-dimensional debugging to improve medication experience.Conclusion The medication experience of patients with chronic multimorbidities should receive extensive attention from society and medical workers,and future research should be conducted to improve the level of patients'medication experience in 5 dimensions,including sensory experience,emotional experience,reflective experience,behavioral experience and associative experience,so as to provide a basis for further improving the medication experience of patients with chronic multimorbidities in China.

Objective:To explore patients and nurses' attitude and willingness of "Internet + nursing services", and provide a reference for better "Internet + nursing services".Methods:In July 2019, totally 579 inpatients and 1 176 nurses from The First Affiliated Hospital of Sun Yat-sen University were selected by convenient sampling. A self-designed Questionnaire on the Status Quo of Patients and Nurses' Attitude and Willingness "Internet + Nursing Services" was used to explore the current status of these patients and nurses' willingness and costs of "Internet + nursing services". χ 2 test was employed to compare the differences between the two. Results:Among respondents, totally 73.40% (425/579) patients and 71.09% (836/1 176) nurses agreed to carry out "Internet + nursing services". A total of 45.08% (261/579) patients and 50.26% (591/1 176) nurses thought that the most needed on-site service items were catheter replacement and wound dressing change. Both patients and nurses believed that on-site services were most helpful to patients with immobility, accounting for 56.18% (325/579) and 52.98% (623/1 176) , respectively. The willingness of nurses to provide on-site services was lower than that of patients to receive on-site services. The cost of nurses' on-site services was higher than the patients' willingness to pay. Patients' concerns about medical risks were higher than those of nurses, while their personal safety concerns were lower than those of nurses. Nurses hoped that the time spent on on-site services was shorter than the needs of patients, and the differences were statistically significant ( P<0.05) . Conclusions:Patients and nurses support the development of "Internet + nursing services". Most patients accept nurses to provide on-site services, while some nurses hold a wait-and-see attitude towards on-site services. Moreover, there is a big gap between the two parties in terms of service costs, risks and duration. Therefore, when carrying out "Internet + nursing services", it is necessary to balance the needs of patients and nurses, formulate practical service plans, and satisfy both nurses and patients to achieve a win-win situation.

Objective To analyze the clinical features and clinical significance of patients with inflammatory bowel disease (IBD) complicated by thrombosis.Methods From March 14th,2001 to February sixth 2017,at Nanjing General Hospital of Nanjing Military Command,27 IBD patients with thrombosis diagnosed by clinical symptoms,endoscopy,imaging and pathology were enrolled.During the same period,81 gender and age matched IBD patients without thrombosis were included in the control group.The basic data,information of IBD diagnosis and treatment and thrombotic events of patients were collected and analyzed.T-test and Chi-square test were performed for statistical analysis.Binary logistics regression was used for risk factors analysis.Results The mean age of diagnosis of IBD patients with thrombosis was (44.8 ± 15.8) years,which was higher than that of the IBD patients of control group ((36.0 ± 14.4) years),and the difference was statistically significant (t =2.69,P =0.008).Among 27 IBD patients with thrombosis,arterial thrombosis was 51.9％ (14/27),deep venous thrombosis of the lower extremity veins was 29.6％ (8/27),portal venous system involved was 11.1％ (3/27),pulmonary embolism was 3.7％ (1/27) and disseminated intravascular coagulation accounted for 7.4％ (2/27).Nine patients (33.3％,9/27) underwent surgery six months before the diagnosis of thrombosis.The results of binary logistic regression indicated that the age of diagnosis and vascular catheterization were independent risk factors for thrombosis in IBD patients (odds ratio (OR) =1.04,95％ confidence interval (CI) 1.01 to 1.07,P=0.01;0R=5.64,95％ CI 1.39 to 22.96,P=0.02).After medicine treatment or surgery,81.5％ (22/27) of the patients improved,9.1％ (2/22) were worse and 13.6％ (3/22) died.Conclusion Screening and prevention of thrombosis should be paid attention in IBD patients with a history of vascular catheterization,at active phase and older age when diagnosed.

Brainstem glioma is a kind of gliomas with focus in the brain stem. At present, surgery is still the preferred treatment for brainstem gliomas. Resection of brainstem gliomas, because of the special anatomical structure and important physiological function, results in extremely high mortality and disability rate, and choosing a reasonable surgical program can significantly improve the prognosis of patients. This article mainly discusses the safe entry zone and surgical approach of brainstem gliomas.

Objective To explore the related factors affecting postoperative pneumonia in patients with cavernous cerebrovascular malformation (CCM).MethodsClinical data of 151 CCM patients admitted to our hospital from January 2010 to January 2017 were retrospectively collected. Patients were divided into postoperative pneumonia group (n=11) and postoperative non-pneumonia group (n=140) according to the occurrence of postoperative pneumonia. Univariate Logistic regression analysis, multivariate Logistic regression analysis and receiver operating characteristic (ROC) curve were used to screen the relevant factors influencing the occurrence of postoperative pneumonia in CCM patients and evaluate the predictive value of relevant factors in postoperative pneumonia.ResultsAs compared with patients from postoperative non-pneumonia group, patients from postoperative pneumonia group had significantly increased modified Rankin scale (mRS) scores and significantly higher percentage of CCM combined with hemorrhage, and significantly decreased Glasgow coma scale (GCS) scores (P<0.05). Multivariate Logistic regression analysis showed that preoperative GCS scores (OR=4.75, 95％CI: 1.14-19.80,P=0.032) and mRS scores (OR=15.61, 95％CI: 3.22-75.58,P=0.001) were independent factors influencing the occurrence of postoperative pneumonia. ROC curve showed that the sensitivity and specificity of mRS scores≥4 to predict postoperative pneumonia were 45.5％ and 95.7％, respectively, and the sensitivity and specificity of GCS scores≤13 to predict postoperative pneumonia were 54.5％ and 85.7％, respectively.ConclusionFor CCM patients with preoperative GCS scores≤13 or mRS scores≥4, more attention should be paid to perioperative lung management and occurrence of postoperative pneumonia should be vigilant.

Objective To evaluate the feasibility and safety of prostatic artery embolization (PAE)via transradial approach in treating prostatic hyperplasia.Methods The clinical data of 18 patients with prostatic hyperplasia,who received C-arm CT-guided PAE via left or right radial artery access,were retrospectively analyzed.The following indexes were recorded:arterial spasm and injury of upper limbs,incidence of puncture point bleeding,postoperative radial artery pulse and congestion,blood supply and nerve injury of fingers,the surgical success rate,incidence of perioperative cerebral vascular complications,operation time,radiation dose and clinical curative effect.Results Among the 18 patients,PAE via left radial artery access was employed in 14,and PAE via right radial artery access was performed in 4.Bilateral PAE was carried out in 16 patients,and only unilateral PAE was able to be successfully accomplished in 2 patients as the prostatic artery opening of the other side was tortuous with stenosis.After PAE,decreased radial pulse was observed in one patient and ultrasound examination revealed decreased blood flow.The operation time ranged from 96 min to 245 min.The radiation dose received by the patient varied from 2435 mGy to 4958 mGy with a mean of (3342±156) mGy,which was not significantly different from the radiation dose received by the patients who underwent PAE via femoral artery access during the same study period (P=0.1167).Conclusion In treating prostatic hyperplasia,PAE by using transradial approach is clinically safe and technically feasible.

Objective To investigate the effect of nutritional guidance on the energy intake and body weight of patients with gastric cancer chemotherapy. Methods The experimental study was used to study the 144 cases with gastric cancer for the first time of chemotherapy. They were randomly divided into the experimental group and the control group, 72 cases in each group. Routine healthy guidance was used in the control group, while the patients in the experimental group were treated by the nutrition prescription, the nutrition guidance, the purpose and the significance of the chemotherapy, and the follow-up of the patients after discharge. The body weight of patients was collected before chemotherapy, and the dietary questionnaire was used for second days after first days of dietary intake, and the changes of energy consumption and body weight were compared between the two groups. Results The mean values of energy intake within 24 hours in the first 3 days after the chemotherapy in the experimental group was 5 068.92 kJ, which was 51%of the RNI. The mean values of energy intake within 24 hours in the first 3 days after the chemotherapy in the control group was 3 439.25 kJ, which was 38%of the RNI. The difference between the two groups was significant (P<0.01). The weight of patients in the experimental group at the time point of before the 5th and 6th time of chemotherapy were significant higher than those in the control group (P<0.05). Energy intake had influenced the patients′weight, high energy intake with low decrease of body weight. Conclusions Nutritional guidance can effectively improve the energy intake of patients with gastric cancer when chemotherapy, so that the weight remained stable during chemotherapy.

Background:Capsule endoscopy has been demonstrated to be an effective diagnostic tool for small bowel diseases in a series of small sample researches. However,the results need to be verified by large sample studies. Aims:To investigate the diagnostic performance and safety of capsule endoscopy for small bowel diseases. Methods:Consecutive patients undergoing capsule endoscopy for suspected small bowel diseases from May 2008 to Apr. 2013 in Nanjing General Hospital of Nanjing Military Command of PLA were collected and analyzed retrospectively. Results:A total of 573 patients were enrolled,the overall success rate of the examination was 99. 13%(568 / 573)and the overall completion rate was 88. 38%(502 / 568). The mean time of capsule passing the pylorus was 43. 45 min,and that of passing the small bowel was 287. 21 min. The overall detection rate of small bowel lesions was 53. 52%(304 / 568)and the overall diagnostic rate was 51. 06%(290 / 568). Both the detection rate and diagnostic rate in patients with obscure gastrointestinal bleeding(OGIB) were significantly higher than those in patients with obscure abdominal pain and chronic diarrhea(64. 26% and 62. 46%vs. 41. 72% and 39. 07% ,and 32. 14% and 27. 38% ,P all < 0. 05). Small bowel lesions detected by capsule endoscopy included angiopathy(21. 38% ),ulceration(20. 72% ),neoplasms(14. 47% ),erosion(11. 84% ),and Crohn’s disease(11. 18%),etc. Capsule retention occurred in 2. 29%(13/568)of the patients,and one acute intestinal obstruction and 2 perforations were observed. Conclusions:Capsule endoscopy is a safe and effective diagnostic modality for small bowel diseases. OGIB is the most common indication for capsule endoscopy,and capsule endoscopy is also helpful for evaluation of established or suspected Crohn’s disease.

Background:Abnormal immune response is involved in the pathogenesis of Crohn’s disease( CD),and T lymphocytes are the main players in the immune response. Aims:To investigate the relationship between peripheral blood CD3 + ,CD4 + and CD8 + T cells and inflammation-related markers in patients with CD. Methods:Proportions of peripheral blood CD3 + ,CD4 + and CD8 + T cells were measured by flow cytometry in 26 CD patients( including 14 patients in active stage and 12 in remission stage )and 8 healthy volunteers(control group),and their correlation with inflammation-related markers(including white blood cell count,platelet count,ESR,CRP,albumin and hemoglobin) were analyzed. Results:Proportions of CD3 + ,CD4 + and CD8 + T cells were significantly increased in patients with active CD than those with remission CD and controls( P ﹤ 0. 05),however,no significant differences were found between remission CD patients and controls(P ﹥ 0. 05). ESR and CRP in active CD patients were significantly higher than those in controls(P ﹤ 0. 05),while albumin and hemoglobin levels were significantly decreased(P ﹤ 0. 05);albumin in remission CD patients was significantly lower than that in controls(P ﹤ 0. 05). No significant differences in white blood cell count and platelet count were found between active,remission CD patients and controls(P ﹥ 0. 05). Proportions of CD3 + , CD4 + and CD8 + T cells were positively correlated with CRP,and negatively correlated with hemoglobin( P ﹤ 0. 05);CD3 + and CD4 + T cells were positively correlated with ESR(P ﹤ 0. 05). However,CD3 + ,CD4 + and CD8 + T cells were not correlated with white blood cell count,platelet count and albumin level( P ﹥ 0. 05). Conclusions:Proportions of peripheral blood CD3 + ,CD4 + and CD8 + T cells are increased with the increase of disease activity in CD,and are positively correlated with CRP,and negatively correlated with hemoglobin.