Objective:To summarize the relevant evidence for prevention and management of stoma prolapse in patients with enterostomy, so as to provide reference for the clinical prevention and management of stoma prolapse measures.Methods:According to the evidence-based resource "6S" evidence pyramid model, systematically searched about the evidence of enterostomy patients prolapse prevention and management in UpToDate, BMJ best practice, Guidelines International Network, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, National Guideline Clearinghouse, CNKI, Wanfang database,VIP Database, SinoMed,etc. The search time limit was from 30 January 2017 to 30 May 2023, 2 researchers independently evaluated the quality of the literature, selected and extracted the evidence.Results:A total of ten articles were included, including one clinical decision, five guidelines, one expert consensus, one evidence, one systematic review, one position statement. Through analysis, 20 best evidences were identified, including perioperative evaluation, preoperative colostomy site marking, reducing abdominal pressure, enterostomy prolapse nursing, health education and the follow-up.Conclusions:Best evidence summary for the prevention and care of stoma prolapse in enterostomy patients provides evidence-based reference for clinical application. Nurses should carefully select and apply evidence in combination with clinical situations and patients′ wishes, so as to develop a personalised stoma prolapse prevention and management programme for patients with enterostomy.

Objective:To investigate the necessity of adaptive re-planning during radiotherapy for nasopharyngeal carcinoma (NPC) and its impact on dose improvement.Methods:Clinical data of 89 NPC patients admitted to Sun Yat-sen University Cancer Center from July 2014 to December 2017 were retrospectively analyzed. All patients received 25+7 rounds of adaptive re-planning during radiotherapy. Plan-A was defined as the initial CT scan-based 25-fraction radiotherapy plan, while plan-B was defined as the re-planned 7-fraction radiotherapy plan based on a subsequent CT scan. The changes in the target and parotid gland volumes were compared between plan-A and plan-B. Plan-I was a one-time simulation of plan-A extended to 32 fraction radiotherapy plan, and plan-II was generated through registration and fusion of the plan-A and plan-B for adaptive re-planning. The differences in dose metrics, homogeneity index (HI), conformity index (CI), and dose to organs at risk (OAR) were compared between plan-I and plan-II. Statistical analysis was performed by using paired t-test. Results:Compared with plan-A, the gross tumor volume of massive bleeding lesions (GTV nx) and parotid gland volume of plan-B were decreased by 13.14% and 11.12%, respectively (both P<0.001). While planning clinical target volume of metastatic lymph nodes (PCTV nd) of plan-B was increased by 7.75%( P<0.001). There were significant changes in the lymph nodes of plan-A and plan-B. The D mean, D 5%, D 95% of massive bleeding lesions planning target volume (PTV nx) and D 5% of high risk planning target volume (PTV1) in plan-II were all significantly higher than those in plan-I (all P<0.05). The CI of PTV nx and PTV1 in plan-II was closer to 1 than that in plan-I. In all assessed OAR, the D mean, D 50%, and D max of plan-II were significantly lower than those of plan-I (all P<0.05). Conclusions:During radiotherapy, NPC patients may experience varying degrees of primary tumor shrinkage, parotid gland atrophy, and lymph node changes. It is necessary to deliver re-planning and significantly improve the dose of target areas and OAR.

Objective To construct a nomogram prediction model for major adverse cardiovascular events(MACE)within 1 year after percutaneous coronary intervention(PCI)in elderly patients with acute coronary syndrome(ACS).Methods A retrospective analysis was conducted on 551 patients with diagnosed ACS and undergoing PCI in Department of Cardiovascular Medicine of Air Force Medical Center from 1 January 2020 to 1 April 2022.According to the occurrence of MACE during 1 year of follow-up,they were classified into MACE group(n=176)and non-MACE group(n=375).Risk factors for the occurrence of MACE in elderly ACS patients within 1 year after PCI were analysed using univariate and multivariate logistic regression,a nomogram prediction model was constructed,and the predictive power of the model was assessed using the area under the ROC curve(AUC).Results The MACE group had significantly higher Gensini score,systemic immune-inflammation index,and GRACE score,but obviously lower prognostic nutritional index than the non-MACE group(P＜0.01).Multivariate logistic regression analysis showed that recent smoking(OR=2.222,95％CI:1.361-3.628,P=0.010),hyperlipidaemia(OR=1.881,95％CI:1.145-3.089,P=0.013),prognostic nutritional index(OR=4.645,95％CI:2.788-7.739,P=0.001),LVEF(OR=5.177,95％CI:3.160-8.483,P=0.001),systemic immune-inflammation index(OR=5.396,95％CI:3.179-9.159,P=0.001),and preoperative di-agnosis of non-STEMI(OR=2.829,95％CI:1.356-5.901,P=0.006)or STEMI(OR=3.451,95％CI:1.596-7.463,P=0.002)were independent influencing factors for occurrence of MACE after PCI in elderly ACS patients.ROC curve analysis showed that the AUC value of the nomo-gram model for predicting MACE within 1 year after PCI in elderly ACS patients was 0.888.Con-clusion Our developed nomogram model is simple and practical,and can effectively predict the occurrence of MACE within 1 year after PCI in elderly ACS patients.And external validation should be carried out to ensure its generality.

Objective: To explore the relationship between parenting style and emotional behavior problems in children with development dyslexia (DD), so as to provide reference for family support and intervention measures. Methods: From June to September 2023, 201 children in DD group and typically developing matched by age and sex were selected from the students in grades 3-6 of 4 primary schools in a district of Xinjiang by random cluster sampling method. The Childrens Version of the Parenting Style Scale and the Strength and Difficulty Scale were administered, and the occurrence of childrens emotional behavior problems and parentingstyles in the two groups were compared by Chisquare test and Wicoxon rank sum test. The correlation between parents parenting styles and childrens emotional behavior problems was analyzed by generalized linear regression. Results: The detection rates of emotional behavior problems were 45.77% in DD group and 15.42% in normal control children group. The differences in parenting styles between fathers and mothers of the DD group and the normal control group were statistically significant in terms of emotional warmth, parenting anxiety, and overprotection (Z=4.02, 29.03; 4.94, 26.32; 23.47, 5.30, P<0.05). Generalized linear regression analysis showed that father affective warmth was positively correlated with emotional symptoms, hyperactivity, peer interaction problems and prosocial behaviors (β=0.08, 0.05, 0.05, 0.09, P<0.05). The emotional warmth of mothers in DD group was negatively correlated with emotional symptoms, conduct problems, hyperactivity and peer interaction problems (β=-0.18, -0.08, -0.07, -0.08, P<0.05). Conclusions Parenting style is an important factor affecting the emotional behavior problems of DD children. Improving parenting style can reduce the occurrence of emotional behavior problems of DD children.

Objective:This study is to investigate the relationship of parental anger expression and symptoms in children with oppositional defiant disorder(ODD).Methods:Forty-six children with ODD and 46 age-gender-matched normal children participated.The Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5),guided the diagnoses.Parental anger expression and children's anger management were assessed using the State-Trait Anger Expression Inventory-2 and Children Emotion Management Scales.Results:ODD symptoms were directly predicted by maternal anger index(AI)(β=0.13,P＜0.05)and anger expression-out(AX-O)(β=0.25,P＜0.05).Children's anger cope(AC)played a mediating function to maternal AI through ODD symptoms,occupying 13％of the total effect;their AC and anger dysregulation(AD)played a mediating function to maternal AX-Othrough ODD symptoms,accounting for 29％and 18％of the total effect,respectively.Conclusion:It sug-gests that anger cope and anger dysregulation in children with oppositional defiant disordermay may play a media-ting role between maternal anger expression and oppositional defiant disorder symptoms.

ObjectiveTo analyze the prevalence of myopia among the primary school students in Shanghai, and to explore its relationship with sleep duration and sleep quality, providing references for precise myopia prevention. MethodsA cross-sectional survey and random sampling were employed. Between April and May 2023, a total of 1 889 students from grades 1 to 5 in Jiading District, Shanghai, were selected for vision testing and a questionnaire on children’s sleeping habits and relevant factors were conducted using the Children’s Sleep Habits Questionnaire (CSHQ) in Chinese. The relationship between myopia and sleep patterns was analyzed using chi-square tests and a multivariate logistic regression model. ResultsThe overall myopia rate among the primary school students in Jiading District, Shanghai, was 35.6%. The results of univariate analysis showed that in the myopia group, the incidences of sleep disturbance and sleep anxiety were lower compared to children without myopia, while the incidences of sleep continuity and parasomnias were higher than there in the non-myopia group (χ²=12.816, 10.292, 10.971, 3.917, all P<0.05). Additionally, among the elementary school students with an average daily sleep duration of less than 10 hours, the prevalence of myopia was higher. The multivariate logistic regression analysis revealed that factors such as being female (OR=1.291, 95%CI: 1.044‒1.597), higher grade levels (2^nd grade: OR=2.174, 95%CI: 1.471‒3.212; 3^rd grade:OR=3.850, 95%CI: 2.648‒5.598; 4^th grade: OR=8.906, 95%CI: 6.154‒12.890; 5^th grade: OR=12.299, 95%CI: 8.433‒17.937), having one parent (OR=2.250, 95%CI: 1.757‒2.881) or both parents(OR=3.623, 95%CI: 2.719‒4.827) with myopia, and parasomnias (OR=1.518, 95%CI: 1.065‒2.163) were associated with a higher detection rate of myopia. ConclusionThe prevalence of myopia is notably high among the primary school students in Jiading District, Shanghai, and there is an association between the occurrence of myopia and parasomnias.

Objective To analyze the application effect of whole-course multi-disciplinary nutrition model in elderly patients undergoing hip surgery.Methods A total of 90 elderly patients undergoing hip surgery admitted to Wenzhou Central Hospital from October 2021 to December 2023 were selected and divided into control group and study group according to random number table method,with 45 cases in each group.The control group was treated with dietary management model,while the study group was treated with whole-course multi-disciplinary nutrition model.Recovery,nutritional status,quality of life,hip function and satisfaction were compared between two groups.Results The hospital stay and fracture healing time in study group were significantly shorter than those in control group(P<0.05).After intervention,prealbumin(PA),albumin(Alb),hemoglobin(Hb),dimensions scores of 36-item short form health survey(SF-36)and Harris hip scores of patients in two groups were significantly higher than before intervention(P<0.05).PA,Alb,Hb,dimensions scores of SF-36 and Harris hip scores in study group were significantly higher than those in control group(P<0.05).The satisfaction of patients in study group was significantly higher than that in control group(χ2=5.075,P=0.024).Conclusion The application of whole-course multi-disciplinary nutrition model in hip surgery in elderly patients can improve their nutritional status,improve their quality of life,enhance hip function,and facilitate postoperative recovery.

Objective:To explore the optimal pulse oxygen saturation (SpO 2) range during hospitalization for patients with sepsis. Methods:A case-control study design was employed. Demographic information, vital signs, comorbidities, laboratory parameters, critical illness scores, clinical treatment information, and clinical outcomes of sepsis patients were extracted from the Medical Information Mart for Intensive Care-Ⅳ (MIMIC-Ⅳ). A generalized additive model (GAM) combined with a Loess smoothing function was employed to analyze and visualize the nonlinear relationship between SpO 2 levels during hospitalization and in-hospital all-cause mortality. The optimal range of SpO 2 was determined, and Logistic regression model along with Kaplan-Meier curve were utilized to validate the association between the determined range of SpO 2 and in-hospital all-cause mortality. Results:A total of 5?937 patients met the inclusion criteria, among whom 1?191 (20.1%) died during hospitalization. GAM analysis revealed a nonlinear and U-shaped relationship between SpO 2 levels and in-hospital all-cause mortality among sepsis patients during hospitalization. Multivariable Logistic regression analysis further confirmed that patients with SpO 2 levels between 0.96 and 0.98 during hospitalization had a decreased mortality compared to those with SpO 2 < 0.96 [hypoxia group; odds ratio ( OR) = 2.659, 95% confidence interval (95% CI) was 2.190-3.229, P < 0.001] and SpO 2 > 0.98 (hyperoxia group; OR = 1.594, 95% CI was 1.337-1.900, P < 0.001). Kaplan-Meier survival curve showed that patients with SpO 2 between 0.96 and 0.98 during hospitalization had a higher probability of survival than those patient with SpO 2 < 0.96 and SpO 2 > 0.98 (Log-Rank test: χ2 = 113.400, P < 0.001). Sensitivity analyses demonstrated that, with the exception of subgroups with smaller sample sizes, across the strata of age, gender, body mass index (BMI), admission type, race, heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, respiratory rate, body temperature, myocardial infarction, congestive heart failure, cerebrovascular disease, chronic liver disease, diabetes mellitus, sequential organ failure assessment (SOFA), simplified acute physiology score Ⅱ (SAPSⅡ), systemic inflammatory response syndrome score (SIRS), and Glasgow coma score (GCS), the mortality of patients with SpO 2 between 0.96 and 0.98 was significantly lower than those of patients with SpO 2 < 0.96 and SpO 2 > 0.98. Conclusions:During hospitalization, the level of SpO 2 among sepsis patients exhibits a U-shaped relationship with in-hospital all-cause mortality, indicating that heightened and diminished oxygen levels are both associated with increased mortality risk. The optimal SpO 2 range is determined to be between 0.96 and 0.98.

Purpose To explore the feasibility of artificial intelligence compressed sensing(ACS)technique in ankle joint MRI.Materials and Methods From September to October 2023,32 healthy volunteers who underwent ankle joint scanning in Beijing Friendship Hospital,Capital Medical University were prospectively collected.MRI of the ankle joint based on ACS and parallel imaging(PI)technology was performed on 3.0T MR.The sagittal proton density weighted imaging(PDWI),coronary PDWI,transverse PDWI and sagittal T1WI were acquired,and all data were divided into test group and control group,with ACS to accelerate the multiples of 5(ACS 5.0)in test group,whereas PI speed ratio of 2(PI 2.0)in control group,respectively.The signal intensity of talus,achilles tendon and cartilage were measured,the signal intensity and standard deviation of the long hallux flexor were obtained,and the signal noise ratio(SNR)and contrast to noise ratio(CNR)were calculated via long hallux flexor as background noise.The data of objective and subjective evaluation of the two sequences were statistically analyzed,and the image quality of each sequence was evaluated via the standard reference of PI 2.0.Results SNR and CNR in ACS group were higher than those in PI group,and the anatomical structure of sagittal PDWI sequence between the two groups had statistical significance(t=-2.937,-1.981,-4.058,-3.879,P<0.05).There were significant differences in cartilage SNR and talus CNR in coronal PDWI sequence(t=-3.310,-3.567;P=0.002,P<0.001).In terms of axial PDWI sequence,there were statistically significant differences in talus CNR and cartilage CNR between ACS and PI groups(t=-4.270,-4.382,P<0.05).The subjective evaluation of the image quality scores of the two groups by the two diagnostic imaging doctors showed a strong observer consistency(Kappa=0.977,P=0.009).There was no significant difference in image quality scores between the two groups(Z=-0.248,-0.747,<0.001,-0.071,P>0.05).The total collection time of ACS group and PI group was 337 s and 610 s,respectively.Compared with PI group,the total scanning time of ACS group was shortened by 44.8%.Conclusion ACS based MRI of the ankle joint can not only shorten the scan time,but also ensure and further improve the image quality,with feasibility.

Hip fracture in the elderly is characterized by high incidence, high disability rate, and high mortality and has been recognized as a public health issue threatening their health. Surgery is the preferred choice for the treatment of elderly patients with hip fracture. However, lower extremity deep venous thrombosis (DVT) has an extremely high incidence rate during the perioperative period, and may significantly increase the risk of patients′ death once it progresses to pulmonary embolism. In response to this issue, the clinical guidelines and expert consensuses all emphasize active application of comprehensive preventive measures, including basic prevention, physical prevention, and pharmacological prevention. In this prevention system, basic prevention is the basis of physical and pharmacological prevention. However,there is a lack of unified and definite recommendations for basic preventive measures in clinical practice. To this end, the Orthopedic Nursing Professional Committee of the Chinese Nursing Association and Nursing Department of the Orthopedic Branch of the China International Exchange and Promotive Association for Medical and Health Care organized relevant nursing experts to formulate Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture ( version 2024) . A total of 10 recommendations were proposed, aiming to standardize the basic preventive measures for lower extremity DVT in elderly patients with hip fractures during the perioperative period and promote their subsequent rehabilitation.