Objective To systematically evaluate the risk factors for pulmonary infection after cardiac surgery. Methods A computer search was performed to collect researches on risk factors for pulmonary infection in patients after cardiac surgery from the databases, including CNKI, Wanfang, VIP, CBM, PubMed, The Cochrane Library, EBSCO, CINAHL, Web of Science, EMbase from the inception to August 2023. Two researchers independently extracted data and assessed the literature according to the inclusion and exclusion criteria, and the quality of the literature was evaluated using the Newcastle-Ottawa Scale (NOS). The meta-analysis was performed using RevMan 5.4 software. Results A total of 23 studies covering 24348 patients were selected, including 21 case-control studies and 2 cohort studies. The NOS scores were≥6 points. The results of meta-analysis showed that age (OR=2.16, 95%CI 1.80 to 2.59, P<0.001), smoking history (OR=1.91, 95%CI 1.67 to 2.18, P<0.001), pulmonary disease (OR=1.61, 95%CI 1.40 to 1.85, P<0.001), diabetes mellitus (OR=1.62, 95%CI 1.26 to 2.08, P<0.001), operation time (OR=2.54, 95%CI 1.86 to 3.46, P<0.001), cardiopulmonary bypass (CPB) (OR=3.78, 95%CI 2.11 to 6.77, P<0.001), CPB time (OR=2.30, 95%CI 1.94 to 2.71, P<0.001), blood transfusion (OR=2.55, 95%CI 2.04 to 3.20, P<0.001), postoperative mechanical ventilation time (OR=2.78, 95%CI 2.34 to 3.30, P<0.001), tracheal intubation time (OR=3.93, 95%CI 2.45 to 6.31, P<0.001) and repeated tracheal intubation (OR=8.74, 95%CI 4.17 to 18.30, P<0.001) were independent risk factors for pulmonary infection in patients after cardiac surgery. Conclusion Age, smoking history, pulmonary disease, diabetes mellitus, operation time, CPB, CPB time, blood transfusion, postoperative mechanical ventilation time, tracheal intubation time, and repeated tracheal intubation are risk factors for pulmonary infection in patients after cardiac surgery. It can be used as a reference to strengthen perioperative evaluation and nursing of high-risk patients and reduce the incidence of pulmonary infection.

Objective To explore the diagnostic value of serum neuronal Per-Arnt-Sim domain protein 4(NPASDP-4)and myelin basic protein(MBP)expression in patients with Parkinson's disease in relation to cognitive impairment(CI)and severity.Methods Selected and 138 Parkinson's disease patients admitted to the 909th Hospital of the Joint Logistics Support Force of the People's Liberation Army of China as the Parkinson's disease group,and 69 healthy people in the physical examination center of the hospital were in the healthy control group.Patients with Parkinson's disease were divided into normal cognitive function group(n=55),mild CI group(n=51)and dementia group(n=32)according to whether CI occurred and its severity.General data of subjects was collected,the serum levels of NPASDP-4 and MBP were detected by ELISA,correlation analysis was adopted by Spearman rank correlation or Pearson linear correlation,diagnostic value was analyzed by ROC curve,and influencing factors were analyzed by multivariate Logistic regression.Results Compared with the healthy control group,the levels of serum NPASDP-4(6.75±0.48 ng/ml vs 2.38±0.31 ng/ml)and MBP(8.34±0.65 μg/L vs 3.54±0.42 μg/L)in the Parkinson's disease group were increased with statistical significance(r=68.751,55.761,all P＜0.05).There were significant differences in H-Y stage among the normal cognitive function group,mild CI group and dementia group(x2=7.788,P＜0.05).Compared with the group with normal cognitive function(47.92±11.63 score),the mild CI group(50.78±13.69 score)and the dementia group(41.95±10.36 score)showed an increase in UPDRS-Ⅲ scores,and the differences were statistically significant(H=6.672,all P＜0.05).In normal cognitive function group,mild CI group and dementia group,the course of disease,and serum NPASDP-4(5.89±0.40,6.83±0.55,8.12±0.54 ng/ml)and MBP(6.65±0.56,8.94±0.69,10.27±0.70μg/L)levels were significantly increased(H=207.950,355.594,allP＜0.05),while MMSE score(28.47±0.94,24.51±1.35,17.09±2.57 score),MoCA score(27.45±1.03,20.18±1.92,11.75±2.53 score)and GPCOG total score(13.47±0.69,10.25±1.04,8.97±0.82 score)were significantly decreased,and the differences were statistically significant(H=515.005,775.933,327.584,all P＜0.05),respectively.The serum levels of NPASDP-4 and MBP in Parkinson's disease patients were significantly positively correlated with the course of disease(r=0.316,0.358),H-Y stage(r=0.345,0.384)and UPDRS-Ⅲ score(r=0.371,0.396),and significantly negatively correlated with MMSE score(r=-0.468,-0.517),MoCA score(r=-0.504,-0.569)and GPCOG total score(r=-0.527,-0.538)(all P＜0.05),respectivey.The areas under the curve(AUC)of the serum levels of NPASDP-4,MBP and their combination in diagnosing of Parkinson's disease were 0.850,0.930 and 0.960,respectively.The AUC of the serum levels of NPASDP-4 and MBP and their combination in diagnosing the severity of CI in patients with Parkinson's disease were 0.866,0.803 and 0.933,respectively.H-Y stage metaphase[OR(95％CI):4.725(1.742～12.814)],H-Y stage advanced[OR(95％CI):5.083(1.919～13.464)],UPDRS-Ⅲ score[OR(95％CI):3.257(1.464～7.246)],NPASDP-4[OR(95％CI):5.324(1.516～18.701)]and MBP[OR(95％CI):5.769(2.459～13.533)]were the influential factors for CI in patients with Parkinson's disease(all P＜0.05).NPASDP-4[OR(95％CI):4.768(2.382～9.543)]and MBP[OR(95％CI);5.846(3.141～10.882)]were the influential factors for the severity of CI in patients with Parkinson's disease(all P＜0.05).Conclusion The serum levels of NPASDP-4 and MBP in patients with Parkinson's disease were high,and they were closely related to CI and its severity,which may have certain clinical diagnostic value.

Objective:To explore the application effect of three mode pre-rehabilitation strategy in gastric cancer patients after laparoscopic radical operation and its effect on the recovery of physical function and quality of life after operation.Methods:Totally 96 patients undergoing elective laparoscopic-assisted radical gastric cancer surgery admitted in the Second Affiliated Hospital of Anhui Medical University from January 2019 to September 2020 were divided into control group (48 cases) and observation group (48 cases) by the random number table. Finally two cases in control group were excluded. The control group received gastric cancer regular preoperative health guidance, the observation group received trimodal pre-habilitation strategy for 6-8 days on the basis of the control group. The perioperative indicators and complications were compared between the two groups. The 36-item Health Survey Summary (SF-36) scores were measured before and after intervention.Results:The first postoperative exhaust time, first out of bed time, first oral meal time, hospital stay in the observation group were (61.49 ± 6.71) hours, (19.54 ± 6.13) hours, (71.23 ± 6.79) days, (5.62 ± 1.03) days, which lower than (79.21 ± 8.15) hours, (22.95 ± 7.19) hours, (78.95 ± 7.21) days, (6.64 ± 1.17) days in the control group, and the differences were statistically significant between the two group ( t values were 2.48-11.53, all P<0.05). The incidence of complications was 6.25% (3/48) in the observation group and 21.74% (10/46) in the control group, and the difference was statistically significant between the two groups ( χ2=8.72, P<0.05). At 1 d before operation and 30 d after operation, the average scores of SF-36 were (68.74 ± 8.02), (65.85 ± 7.44) points in the observation group and (60.73 ± 7.43), (61.04 ± 6.85) points in the control group, and the differences were statistically significant ( t=5.02, 3.26, both P<0.05). Conclusions:Preoperative three mode pre-rehabilitation training for gastric cancer patients is beneficial to improving the state of exercise, nutrition and immune function, speeding up postoperative gastrointestinal function and overall rehabilitation, reducing the incidence of postoperative complications and improving the quality of life of patients.

The cultivation of medical students' scientific research and innovation ability is the need of our country to accelerate the construction of an innovative country. This paper starts from the significance of strengthening the cultivation of medical students' scientific research and innovation ability, emphasizes participation in teacher's scientific research in colleges and universities to strengthen the feasibility of the medical students' scientific research and innovation ability cultivation, and summarizes the practical experience of cultivating medical students' scientific research ability based on scientific research projects of teachers in colleges and universities, which can provide reference for peers.

Objective:To explore the effect of enhanced recovery nursing pathway in the enhanced recovery after surgery of perioperative patients with hepatic echinococcosis.Methods:From November 2017 to February 2019, simple random sampling was used to select 160 hepatic echinococcosis patients with surgery admitted to Shannan People's Hospital of Tibet Autonomous Region as the research object. Patients were randomly divided into experimental group and control group, 80 cases in each group. Patients in control group received general surgical routine nursing, and experimental group carried out enhanced recovery nursing pathway on the basis of routine nursing. The postoperative rehabilitation indicators, pain scores and postoperative complications were compared between the two groups.Results:The time of first exhaust time and defecation in experimental group was (3.77±3.05) h and (23.81±17.29) h, which was earlier than (13.27±8.58) h and (37.79±18.23) h in control group, and the differences were statistically significant ( t=4.265, 4.975; P<0.01) . The pain scores of experimental group at 2, 4, 8, and 24 hours after surgery were (1.08±1.04) , (1.61±0.85) , (1.13±0.70) and (0.26±0.41) lower than those [ (2.41±1.20) , (2.94±0.96) , (2.94±0.96) , (1.33±0.90) ]of control group, and the differences were statistically significant ( t=7.501, 9.250, 13.650, -8.720; P<0.01) . There were 2 cases (2.50%) of lung infection in experimental group and 13 cases (16.25%) in control group. The incidence in experimental group was lower than that in control group, and the difference was statistically significant (χ 2=8.901, P<0.01) . Conclusions:The standardized nursing model based on the enhanced recovery nursing pathway is conducive to the postoperative rehabilitation of patients with hepatic echinococcosis, shortens the hospital stay, and reduces postoperative lung infection complications, which is worthy of further promotion.

OBJECTIVES: To evaluate curative effects of coronavirus disease 2019 (COVID-19) patients by the transfusion of other convalescent plasma. METHODS: Retrospective analysis of the clinical data of 18 patients with severe and critical COVID-19, who were hospitalized in the ICU of Xianghu Branch of the First Affiliated Hospital of Nanchang University from February 1 to March 15, 2020. Patients were subdivided into an experimental group (=6, who had transfused the plasma) and an observation group (=12, who had no plasma transfusion). Basic clinical data and prognosis indexes of these two groups were compared. Moreover, for the experimental group, the dynamic changes of blood oxygen saturation before and after the transfusion, the changes of lymphocyte absolute value 48 hours after the transfusion, and the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid were analyzed. RESULTS: There were no significant differences in age, gender, blood type and other basic clinical data between the two groups (all >0.05).There were no significant differences in ventilator machine weaning time, extracorporeal membrane oxygenation (ECMO) weaning time, body temperature recovery to normal time, and hospitalization days between these two groups (all >0.05). For the experimental group, before, during and after the convalescent plasma transfusion, the blood oxygen saturation of all 6 patients at all time (1, 6, 8, 12, 24, 36, and 48 h) was more than 90%, and there was no significant fluctuation. There were 3 patients whose absolute value of lymphocyte was increased 48 hours after the transfusion, and the remaining was decreased. There were 5 patients whose SARS-CoV-2 nucleic acid detection turned negative 48 hours after the transfusion, accounting for 83.3%. CONCLUSIONS Transfusion of convalescent plasma will not affect outcomesof COVID-19 patients, which can neutralize SARS-CoV-2 in patients and reduce the loading capacity of SARS-CoV-2.
Betacoronavirus ; Blood Component Transfusion ; China ; Coronavirus Infections ; therapy ; Humans ; Immunization, Passive ; Pandemics ; Plasma ; Pneumonia, Viral ; therapy ; Retrospective Studies

Objective:To investigate the status quo of attitude towards death among nursing students before internship and analyze its influencing factors so as to provide basis for nursing educators to formulate death education strategies.Methods:From May to June 2019, a total of 225 nursing students from 8 medical colleges in Anhui Province were selected as research objects by convenient sampling method. The general information questionnaire and the Chinese version of Death Attitude Profile-Revised (DAP-R) were used to investigate it. Multiple linear regression analysis was used to analyze the influencing factors of attitude towards death.Results:The total score of DAP-R of 225 nursing students before internship was (88.03±14.81) . The scores of the five dimensions from high to low were: natural acceptance, death avoidance, death fear, approach acceptance and escape acceptance. Univariate analysis showed that scores on attitude towards death of nursing students with different education backgrounds, the atmosphere when discussing death at home and whether they had received death education were statistically significant ( t=2.528, 5.130, 2.684; P < 0.05) . Multiple linear regression analysis showed that educational background, the atmosphere when discussing death at home and whether receiving death education were influencing factors of attitude towards death before internship ( P < 0.05) , which explained 7.8% of the total variation. Conclusions:The attitude towards death before internship among nursing students from 8 medical colleges in Anhui Province is at a medium level. Educators should formulate death education courses according to their attitudes to death and carry out various forms of death education according to their influencing factors so as to cultivate correct life and death views for nursing students.

Objective: To explore the clinical application of the deep inferior epigastric artery perforator flap in bilateral breast reconstruction of patients with breast cancer. Methods: Deep inferior epigastric artery perforator flap was applied for breast reconstruction in four cases of breast cancer patients received radical or modified radical surgery in Hunan Provincial Cancer Hospital. All patients are female, age ranged from 31 to 53 years old (36.2±5.9). Results: The length of flap was (15.1±0.4) cm, the width of flap was (12.6±0.3) cm, the thickness of flap was (4.3±0.5) cm. The length of pedicle was (12.6±0.3) cm, the outer diameter of artery was (1.8±0.2) mm, the outer diameter of vein was (2.1±0.4) mm.The average weight of flaps was 235 g(ranged from 195 g to 335 g). In one case flap fat necrosis occurred and in other one donor site fat necrosis was noted. The two flaps both healed with dressing treatment and no other complications were found. The reconstructed breasts′shape, texture and elasticity were good and no flap contracture deformation happened. Only linear scar left in the donor sites, the function of abdomen did not affected. All 4 patients were followed up for 14 to 33 months (21.7 months on average) with satisfied result. No local recurrence happened. Conclusions Free deep inferior epigastric artery perforator flap is suitable to reconstruct bilateral breast for breast cancer patients.

Objective? To explore the effects of family function on the health-related quality of life in children with short stature. Methods? A total of 200 children aged 3 to 15 and their parents in the Department of Pediatrics in a Class Ⅲ Grade A hospital in Anhui province from August 1st, 2018 to December 31st, 2018 were selected in the study. Based on the admission criteria, 100 children with short stature were selected and put into the observation group, and 100 children with normal height were selected randomly and put into the control group. Family Intimacy and Adaptability Scale (FACESⅡ-CV) and Chinese version of the Pediatric Quality of Life Inventory 4.0 General Core Scales (PedsQLM 4.0) were used to investigate and analyze the influencing factors of the life quality of the children. Results? The scores of "physiological function", "emotional function","social function" and "school function" as well as the scores of "family intimacy" and "adaptability" in FACES Ⅱ-CV in the observation group were lower than those in the control group with statistical significance (P＜ 0.05). Family intimacy and adaptability was positively correlated with the four dimensions of "physiological function""emotional function" "social function" and "school function" in the observation group of children with short stature (P＜ 0.05). Conclusions? The subjective quality of life of children with short stature is low. Family function had an influential impact on the quality of life in children with short stature. It indicates that good family function can improve the quality of life of children with short stature. Therefore, parents should actively improve the way they educate their children, enhance communication, accurately monitor their children＇s psychological features, timely regulate their children with individualized measures, so as to improve the family function hence contributing to better quality of life for the children.

With the global aging, the incidence rate of HCC in the elderly population is gradually increasing , and thus it has become a global health issue.With reference to relevant literature, this article analyzes the clinical features of elderly HCC patients and reviews the current status of therapies and clinical outcomes .The review of clinical outcomes is mainly based on the comparison of therapeutic outcome between elderly and non -elderly HCC patients in many countries and regions in the world .This article points out that elderly HCC patients have their own clinical features, and since elderly HCC patients often have other diseases , such as diabetes, renal failure, and lung and cardiovascular diseases, there is an increase in the risk of treatment, but they often have positive treatment outcomes .With the deepening of research and the improvement of various treatment methods , the therapeutic outcome of elderly HCC patients will also be improved .Therefore,positive attitude and strategies should be adopted in the clinical treatment of elderly HCC patients .