The intestinal flora and gut barrier function are of great significance for gut function and human health. When the intestinal flora is disrupted and the gut barrier structure is disrupted, it can lead to bacterial translocation, endotoxin influx into the bloodstream, and the production of pro-inflammatory factors, leading to various tissue damage in the body. Tongfu method in TCM can affect the intestinal environment by regulating intestinal permeability and immune response, restoring normal intestinal movement, and regulating the structure and metabolites of intestinal flora, thereby maintaining intestinal homeostasis and body health. The research on regulating intestinal flora and improving intestinal barrier function by Tongfu method can provide reference for further research on the relationship between TCM and intestinal microecology, and provide ideas for clinical treatment.

【Objective】 To establish a risk model for predicting spontaneous rupture bleeding of renal angiomyolipoma (RAML) in order to better assess and deal with the risk. 【Methods】 The information of 436 RAML patients diagnosed during Jan.2018 and Dec.2022 was retrospectively analyzed.According to the inclusion and exclusion criteria, 216 patients were included and divided into the rupture bleeding group (n=35) and non-rupture bleeding group (n=181).The factors influencing spontaneous rupture bleeding were identified using univariate and multivariate analysis, and a nomogram was constructed accordingly with R language.The nomogram was evaluated using Calibration curve and area under the receiver operator characteristic curve (AUC). 【Results】 It was found that clinical manifestations, tumor diameter, tumor convexity, tumor blood supply, and tuberous sclerosis complex (TSC) were significantly correlated with rupture bleeding.The Calibration curve fitted well with the nomogram.The AUC was 0.956 (95%CI: 0.856-0.943), indicating that the nomogram had good statistical performance. 【Conclusion】 The model can effectively predict the risk of spontaneous rupture bleeding of renal angiomyolipoma.

Objective To understand the implementation of the nursing group standards for oxygen inhalation therapy in clinical practice,and to provide a reference for improving the nursing practice of oxygen therapy.Methods A convenience sampling method was used to investigate nurses from 902 hospitals in 24 provinces and municipalities directly under the central government using a self-designed questionnaire from December 15th,2022,to January 14th,2023.The content of questionnaire included whether they had implemented the recommendations of the oxygen therapy standards,the knowledge of safety related to oxygen therapy,and the components of oxygen therapy prescriptions,the indications used for patients receiving oxygen therapy and practice status of oxygen therapy.Results A total of 10481 questionnaires were returned,of which 10447 were valid,with a valid questionnaire recovery rate of 99.68%.63.14%of the nurses indicated that the hospital had organized training on oxygen therapy standards.Only 47.82%of nurses know the correct use of the Venturi mask.41.90%of nurses could indicate the correct indicator of flow adjustment.31.88%of the nurses stated that they will adjust the oxygen flow rate based on the oxygenation status of carbon dioxide storage patients.Only 19.56%of nurses indicated that humidification is applied in oxygen therapy based on the oxygen flow and duration.Conclusion Even though nurses had received training related to oxygen therapy standards,the level of knowledge of oxygen therapy standards was still low;therefore continuous systematic training was needed,and the implementation of the content of oxygen therapy standards needed to be further standardized.Healthcare institutions would focus on organizing systematic training and maintaining the training effect,enhancing infrastructure and providing support for implementation.Recommendation to the nursing administration is to explore how to comprehensively and continuously implementing the oxygen therapy nursing standards with the ultimate goal of providing patients safer and more accurate oxygen therapy.

Objective The prediction of RR intervals in hypertensive patients can help clinicians to analyze and warn patients'heart condition.Methods Using 8 patients'data as samples,the RR intervals of patients were predicted by long short-term memory network(LSTM)and gradient lift tree(XGBoost),and the prediction results of the two models were combined by the inverse variance method to overcome the disadvantage of single model prediction.Results Compared with the single model,the proposed combined model had a different degree of improvement in the prediction of RR intervals in 8 patients.Conclusion LSTM-XGBoost model provides a method for predicting RR intervals in hypertensive patients,which has potential clinical feasibility.

Objective : To study the best machine learning method for early prediction of hematoma expansion in hypertensive intracerebral hemorrhage based on head CT plain scan. Methods : The CT images of 130 patients with cerebral hemorrhage were retrospectively analyzed , and the texture features of the head CT plain scan were extracted. The classifier was trained by selecting the features , and the six classic machine learning methods were crossvalidated to evaluate the stability and performanceof predicting cerebral hemorrhage hematoma expansion. Results: The prediction performance of support vector machine (SVM⁃Radial) (AUC 0. 714 ± 0. 144 , accuracy 0. 723 ± 0. 109) , generalized linear model ( GLM) prediction performance ( AUC 0. 643 ± 0. 125 , accuracy 0. 587 ± 0. 136) , random forest (RF) prediction performance (AUC 0. 686 ± 0. 128 , accuracy 0. 680 ± 0. 130) , k ⁃nearest neighbor (kNN) prediction performance ( AUC 0. 657 ± 7C 15 , accuracy 0. 639 ± 39 performance 19) , gradient boosting tree algorithm (GBM) Prediction performance ( AUC 0. 718 ± 0. 141 , accuracy 0. 670 ± 0. 126) , neural network (NNet) prediction performance (AUC 0. 659 ± 0. 162 , accuracy 0. 680 ± 0. 130) , in which support vector machines showed high prediction performance , generalized linear model showed low predictive performance. Conclusion Among the six machine learning methods based on cranial CT radiomics to predict early hematoma expansion in hypertensive intracerebral hemorrhage , support vector machine (SVM⁃Radial) has the best predictive performance and has potential clinical application value.

【Objective】 To explore the relationship between preoperative anemia and perioperative red blood cell (RBC) transfusion and postoperative outcomes in patients undergoing mitral valve surgery. 【Methods】 The clinical data, laboratory findings, blood transfused and outcomes data of 493 patients who underwent mitral valve surgery in Fuwai Hospital in 2017 were collected by blood transfusion management system and retrospectively analyzed by SPSS. The patients were divided into anemia group (n=34, male Hb<120 g/L and female Hb<110 g/L) and non-anemia group (n=459) .The measurement data were statistically analyzed with t test or rank sum test, and enumeration data by Fisher test and Chi-square test, and then all analyzed by binary logistics regression. 【Results】 The incidence of anemia before mitral valve surgery was 6.90% (34/493). Perioperative erythrocyte dosage (U) (median), erythrocyte transfusion rate, ICU stay time (d) (median) and hospital mortality rate(%) in anemia group and non-anemia group were 4.00 vs 0.00 (OR: 2.55, 95% CI: 1.70~3.40, P<0.05), 67.65% vs 21.35% (OR: 12.98, 95% Cl: 5.21~31.15, P<0.05), 2.50 vs 2.00 (B: 0.71, 95% Cl: 0.08~1.33, P<0.05) and 5.88 vs 0.22(P<0.05)respectively. 【Conclusion】 Preoperative anemic is independently associated with perioperative RBC transfusion in patients undergoing mitral valve surgery, and may increase ICU length of stay and hospital mortality.

Objective:To compare the optimal gridpercutaneous vertebroplasty (PVP) and conventional PVP in the treatment of osteoporotic vertebral compression fractures (OVCFs).Methods:A retrospective cohort study was conducted of 102 patients with OVCFs who had underwent PVP between May 2016 and May 2019 at department of spine surgery, General Hospital of Northern Theater Command. According to the different surgical methods, they were divided into the optimalgrid PVP group (102 cases) and conventional PVP group (94 cases). In the optimal grid PVP group, there were 38 males and 64 females with an average age of 67.3±8.5 years old, and the course of disease was 2.3±1.2 days; the injured sites were lumbar vertebra, including 59 cases of L 1 vertebra, 31 cases of L 2 vertebra, 8 cases of L 3 vertebra, 3 cases of L 4 vertebra and 1 case of L 5 vertebra. In the conventional PVP group, there were 26 males and 68 females with an average age of 71.5±5.6 years old, and the course of disease was 2.1±1.1 days; the injured sites were lumbar vertebra, including 52 cases of L 1 vertebra, 33 cases of L 2 vertebra, 7 cases of L 3 vertebra and 2 cases of L 4 vertebra. The patients were prepared before operation. Then the best puncture point was selected, and the guide wire and working channel were inserted. Finally the bone cement was pushed. The operation time, intraoperative fluoroscopy times, bone cement dosage and bone cement leakage were compared between the two groups. Visual analogue scale (VAS), anterior heights and median heights of injured vertebra were compared between the two groups at postoperative 3 days, 3 months and the final follow-up. Results:There were no significant differences in the general clinical data between the two groups before operation ( P>0.05). All patients had no complications such as wound infection,pulmonary embolism,spinal cord embolism or death. The operation time, fluoroscopy times, bone cement dosage and bone cement permeability of the two groups were statistically significant different ( P<0.05), and the optimal grid group was better than the conventional group. VAS at 3 days, 3 months and the final follow-up was statistically significantlower in the optimal grid group than the conventional group ( P<0.05). There was no significant difference in the recovery of the anterior and middle edge heights of injured vertebra in the two groups 3 days after operation ( P>0.05), but there were statistical significant difference between the two groups3 months after operation and at the last follow-up ( P<0.05), whilethe optimal grid group was better than the conventional group. Conclusion:Compared with conventional PVP, the optimal grid PVP is safer and more effective in the treatment of osteoporotic vertebral compression fractures.

Objective:To evaluate the effects of supra-arch branches bypass on cerebral oxygen saturation and hemodynamics in patients with Stanford type B aortic dissection.Methods:From January to December 2018, consecutive 27 patients with Stanford type B aortic dissection were enrolled in the study. All patients received hybrid treatment, including supra-arch branches bypass(right axillary artery-left common carotid artery-left subclavian artery) and thoracic endovascular aortic repaire(TEVAR). All the operations were performed by the same surgical team. The left and right cerebral oxygen saturation were measured after anesthesia(T1), left carotid artery occlusion(T2) and after operation(T3); peak systolic velocity(PSV) and resistance index(RI) of left and right carotid arteries were measured before(t1) and after operation(t2).Results:The left cerebral oxygen saturation was 0.62 ±0.01, 0.54±0.01 and 0.62±0.01 at T1, T2 and T3, respectively. There was significant difference between T2 and T1 and T3( P=0.002, P=0.001), but there was no significant difference between T1 and T3. The PSV of left carotid artery at t1 and t2 were(0.91±0.11)m/s and(0.76±0.09)m/s respectively, with no significant difference( P= 0.191). The RI of left carotid artery at t1 and t2 were 0.83±0.06 and 0.93±0.13 respectively, with no significant difference( P= 0.575). Conclusion:If one side of carotid artery was blocked for a short time during supra-arch branches bypass, the cerebral oxygen saturation would be decreased temporarily, but the changes of cerebral oxygen metabolism could be completely restored after operation. However, the hemodynamics of carotid artery would not change significantly. In the hybrid treatment strategy for the patients with aortic dissection Stanford type B, blocking bilateral carotid arteries can be avoided. Making the right axillary artery-left common carotid artery-left subclavian artery shunt is a safe and effective choice.

This paper introduced the background and application method of healthcare failure mode and effect analysis (HFMEA) to understand the application of HFMEA mode in the operation room nursing management at home and abroad, and explored its application value in nursing management of operating room. It can provide experience for the application of HFMEA in nursing process of operating room, so as to better reduce the incidence of nursing risk in operating room, protect patients' life safety and improve the quality of nursing.

Objective To explore the effect of mobile internet management in continuing nursing care of premature infants. Methods The convenience sampling method was adopted to divide the premature infants from January to December in the year 2015 into 2 groups according to the time order, the control group (n = 56), and the observation group (n = 57). The control group received continuing nursing care for the whole course from admission to discharge. Based on the nursing care of the control group, the observation group were given an extra continuing nursing care by using the mobile internet. Both group's continuing nursing care were lasted from the birth till 12 month.Comparisons of two groups were made from the following aspects: of preterm infants born at 12 months in the length, weight, head circumference of the preterm infants at 12 months old and 40 weeks corrected gestational age Neonatal Behavioral Neurological Assessment,breastfeeding confidence;parents care knowledge scores at the time of admission, discharge and 1month after discharge; referral rate; parents satisfaction at the time of discharge and the end of extended care). Results In the observation group,the length,weight and head circumference of the preterm infants at birth were(74.10 ± 2.66)cm,(8.70 ± 1.43)kg,(45.40 ± 1.38)cm, Neonatal Behavioral Neurological Assessment at 40 weeks of gestation,self-confidence in breastfeeding,1 post-discharge and 1 post-discharge parents care knowledge score of the month, parents of preterm children satisfaction scores, respectively(37.30 ± 3.22),(120.31 ± 13.65),(82.28 ± 3.99, 96.70 ± 2.28), (93.55±2.91,96.61±2.37),the control group were(73.20±2.80)cm,(8.44±1.02)kg,(44.2±1.40)cm, (36.00±2.87),(114.54±12.21),(80.66±3.51, 95.02±3.87),(92.57±2.41, 95.72±2.02). The difference between the two groups was statistically significant(t=-5.244~-2.014,all P<0.05). Conclusions The mobile internet application of continuing nursing care in premature infants can improve the growth and development of premature infants and maternal breastfeeding confidence,promote parents care knowledge, referral rate and satisfaction,thus guarantee the he living quality of the preterm infants.