Objective To conduct a scoping review of research on the application of mobile health(mHealth)in the management of home enteral tube feeding,so as to provide references for future research and clinical practice.Methods A literature search was performed in the PubMed,Cochrane Library,Embase,Web of Science,CINAHL,CNKI,Wanfang,and CMB databases to identify relevant studies.The search period spanned from the establishment of databases until February 18,2024.According to the scoping review framework,2 researchers independently screened the studies,extracted the data of the included studies,and collaborated on the final analysis.Results A total of 24 studies were included.9 studies were conducted with interventions based on nursing models such as discharge planning model,"Hospital to Home"nutrition management model,guided care nursing model.The management forms included application,network communication software,and website.The content elements included education,assessment,consultation,referral,self-management,electronic health archive,appointment service,peer support.The outcome indicators included patients'physical and mental health,self-management ability,caregiver competence,family burden and user assessment.Conclusion The mHealth has played a positive role in the management of home enteral tube feeding.In the future,it is recommended to establish a multidisciplinary team to conduct high-quality research and continuously improve the form and content of mHealth management.

Objective To analyze the influencing factors of frailty in elderly patients with lower extremity osteoarthritis,and to construct and validate the risk assessment model.Methods Convenient sampling method was used to select 535 elderly patients with lower extremity osteoarthritis from tertiary hospitals and community health service centers in Hangzhou from January to September 2022 as the survey subjects including 357 in the modeling group and 178 in the validation group.Univariate and multivariate logistic regression analysis were used to determine the risk factors of frailty,construct a risk assessment model and draw a nomogram.The discrimination and calibration of the model were evaluated by the area under the receiver operating characteristic curve and the Hosmer-Lemeshow test.The Bootstrap method was used for intemal validation of the model,and the time verification method was used for external validation.Results The model variables included the number of affected joints,age-adjusted Charlson comorbidity index,pain,nutritional status,sedentary time,activity of daily living,osteoarthritis index,lower limb muscle strength,and Social Support Rating Scale score.The Hosmer-Lemeshow test results of the model showed that P=0.202,the area under the receiver operating characteristic curve was 0.942,the optimal critical value was 0.392,the sensitivity was 0.914,the specificity was 0.893,and the accuracy rate was 0.902.The internal and external validation showed that the C-statistics were 0.935 and 0.919,respectively,and the calibration curve showed good fitting.Conclusion The risk assessment model has a good degree of discrimination and calibration,which can more intuitively and easily screen elderly patients with lower extremity osteoarthritis at high risk of frailty,and provide references for early monitoring,identification,prevention and control.

Objective:To sort out the development context of precision nursing and compare and analyze the advantages and shortcomings in this field at home and abroad, so as to provide reference for the development of precision nursing in China.Methods:Through Web of Science core collection and CNKI database, literature related to precision nursing at home and abroad from January 1, 2012 to December 31, 2022 was retrieved. CiteSpace software was used to draw a scientific knowledge map for visualization analysis.Results:A total of 509 literatures in Chinese and 1 037 literatures in English were detected, and the annual number of publications showed a significant upward trend since 2015. The high-yielding institutions were mostly located in the United States, and the distribution of domestic institutions was relatively dispersed. From the perspective of research hotspots and frontiers, foreign research focused on health promotion and disease prevention research oriented by biological information, while Chinese research focused on individualized nursing research oriented by patient needs.Conclusions:In recent 10 years, the research of precision nursing in China has developed rapidly, but relatively speaking, the depth and breadth of its research still need to be improved. Chinese research should learn from the experience of foreign precision nursing practice and explore the mode of precision nursing that conforms to national conditions in China.

Objective:To systematically review the risk prediction model for vaginal delivery failure in low-risk primiparas, so as to provide reference for clinical practice and future research.Methods:Literature on the risk prediction model for vaginal delivery failure in low-risk primiparas was retrieved from China National Knowledge Infrastructure, WanFang Data, China Biology Medicine disc, PubMed, Embase, Cochrane Library, CINAHL, Web of Science and so on. The search period was from the establishment of the database to September 20, 2023. Two researchers independently screened literature, extracted data, and evaluated the risk of bias in the included studies.Results:A total of 10 articles were included, involving 14 models. Twelve models were constructed using Logistic regression, and the area under the receiver operating characteristic curve of the models ranged from 0.680 to 0.847. Common predictive factors of the model involved age of pregnant woman, height of pregnant woman, pre-pregnancy body mass index, gestational weight gain, gestational week, fetal birth weight, induction method, fetal biological measurements, and pre-delivery cervical Bishop score.Conclusions:The predictive performance of the vaginal delivery failure risk prediction model for low-risk primiparas is good, but the model construction method is relatively simple, and the overall bias risk is high. The model needs to be further optimized through machine learning, artificial intelligence, and other means, and extensively validated externally.

Objective:To summarize and evaluate the best evidence for nonpharmacological interventions in patients with post-stroke depression.Methods:Based on the "6S" pyramid model of evidence resources, the Chinese and English databases and websites of relevant professional associations were systematically searched for evidence on nonpharmacological interventions in patients with post-stroke depression, including guidelines, evidence summaries, systematic reviews, and expert consensus. The retrieval time limit was from the establishment of the database to July 31, 2021. The quality of the article was independently evaluated by two researchers, and evidence was extracted and summarized for the article that met the quality standards.Results:A total of 15 articles were included, including 4 guidelines, 1 evidence summary, 9 systematic reviews, and 1 expert consensus. A total of 25 pieces of the best evidence were compiled from five aspects, namely, health education, exercise intervention, psychological intervention, physical intervention and traditional Chinese medicine techniques.Conclusions:Medical and nursing staff should formulate nonpharmacological interventions for post-stroke depression patients according to the specific clinical conditions and patient characteristics, and apply the evidence in clinical practice.

Objective:To explore the clinical effect of a modified aponeurosis-resection surgery.Methods:From June 2017 to January 2018, a total of 34 patients (66 eyes) with mild to moderate congenital ptosis were treated in Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, including 2 males and 32 females, (26.6 ± 7.6) aged, with mild 49 eyes and moderate 17 eyes. All patients underwent a modified aponeurosis-resection surgery by buried guiding suture. During the operation, guided sutures were run on the deep surface of the levator-Muller’s muscle complex, and the complex was sutured and fixed on the tarsal plate. Follow-up of the postoperative outcome was performed. The distance between the upper eyelid margin covering the upper edge of the cornea was recorded before operation, 3 months, 6 months, and 12 months after operation. The correction of ptosis was analyzed by the analysis of variance.Results:For the 34 patients (66 eyes), the distance between the upper eyelid margin covering the cornea before surgery, 3 months, 6 months, and 12 months was (3.84 ± 0.79) mm, (1.64 ± 0.13) mm, (1.67±0.14) mm, and (1.68 ± 0.14) mm. The difference between the initial value and the preoperative value was statistically significant ( P<0.01). During the follow-up period, no significant complications, such as infection, trichiasis, blepharoplasty, exposed keratitis, eyelid appearance, and conjunctival prolapse, were observed in all 34 patients. 1 case of blepharoplasty suture was lost and then repaired. The remaining 33 patients had satisfactory correction of the upper eyelid, good apperance, and bilateral symmetry. Two of them (4 eyes) had a slight decrease in the upper eyelid margin height, but still normal range, all patients were satisfied with the surgical result. Conclusions:The modified aponeurosis-resection surgery is effective in treating mild and moderate ptosis, with simple procedure, stable adhesion formation, and long-term eyelid function and appearance.

Objective:To explore the clinical effect of a modified aponeurosis-resection surgery.Methods:From June 2017 to January 2018, a total of 34 patients (66 eyes) with mild to moderate congenital ptosis were treated in Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, including 2 males and 32 females, (26.6 ± 7.6) aged, with mild 49 eyes and moderate 17 eyes. All patients underwent a modified aponeurosis-resection surgery by buried guiding suture. During the operation, guided sutures were run on the deep surface of the levator-Muller’s muscle complex, and the complex was sutured and fixed on the tarsal plate. Follow-up of the postoperative outcome was performed. The distance between the upper eyelid margin covering the upper edge of the cornea was recorded before operation, 3 months, 6 months, and 12 months after operation. The correction of ptosis was analyzed by the analysis of variance.Results:For the 34 patients (66 eyes), the distance between the upper eyelid margin covering the cornea before surgery, 3 months, 6 months, and 12 months was (3.84 ± 0.79) mm, (1.64 ± 0.13) mm, (1.67±0.14) mm, and (1.68 ± 0.14) mm. The difference between the initial value and the preoperative value was statistically significant ( P<0.01). During the follow-up period, no significant complications, such as infection, trichiasis, blepharoplasty, exposed keratitis, eyelid appearance, and conjunctival prolapse, were observed in all 34 patients. 1 case of blepharoplasty suture was lost and then repaired. The remaining 33 patients had satisfactory correction of the upper eyelid, good apperance, and bilateral symmetry. Two of them (4 eyes) had a slight decrease in the upper eyelid margin height, but still normal range, all patients were satisfied with the surgical result. Conclusions:The modified aponeurosis-resection surgery is effective in treating mild and moderate ptosis, with simple procedure, stable adhesion formation, and long-term eyelid function and appearance.

Objective To construct the syndrome differentiation nursing plan for end-of-life patients with digestive symptoms so as to provide an objective evidence for the standardizing and popularizing the traditional Chinese medicine (TCM) nursing operation in end-of-life patients. Methods The initial syndrome differentiation nursing recommendations for end-of-life patients with digestive symptoms were constructed based on literature review combined with digestive symptoms characteristics of end-of-life patients including the digestive syndromes end-of-life patients, TCM nursing operation, operation method and considerations. The method of Delphi expert consultation was used to two rounds of consultation by 16 experts and to calculate the expert positive coefficients and expert authority coefficient (Cr); item importance was analyzed with the mean, variation coefficient (CV) and Kendall's concordance coefficient (Kendall's W) to finally determine the syndrome differentiation nursing plan for end-of-life patients with digestive symptoms. Results Around two rounds of expert consultation, there were 16 valid questionnaires respectively. The expert positive coefficients and Cr were 100％ and 0.89 respectively. Variation coefficients of all indexes ranged from 0.05 to 0.27,which were <0.03; the Kendall's W ranged from 0.13 to 0.43 (P<0.01). Conclusions The syndrome differentiation nursing plan for end-of-life patients with digestive symptoms based on literature review and Delphi method standardizes the application of TCM nursing operation in end-of-life patients which has practical value on improving the quality of life of end-of-life patients and availability of medical resources.

Objective:To explore the effects of rhubarb enema combined with intra-abdominal pressure (IAP) monitoring in enteral nutrition (EN) therapy among critical patients.Methods:From August 2017 to August 2018, this study selected 68 EN patients of ICU at a Class Ⅲ Grade A hospital in Hangzhou as subjects by convenience sampling. All of patients were randomly divided into experimental group and control group, 34 cases in each group. Control group carried out the EN treatment guided by IAP monitoring. On the basis, experimental group combined the rhubarb enema for 5 days. This study compared the score of Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ, IAP, incidence of feeding intolerance (FI) and feeding volume reaching the standard of patients between two groups.Results:After intervention, the score of APACHE Ⅱ of patients in experimental group was lower than that in control group with no statistical difference ( P>0.05) . The IAP of patients in experimental group was lower than that in control group with a statistical difference ( P<0.01) . The time of feeding volume reaching the standard of patients in experimental group was shorter than that in control group with a statistical difference ( P<0.01) . The incidence of FI of experimental group was lower than that in control group with a statistical difference ( P<0.05) . Conclusions:Rhubarb enema combined with IAP monitoring can reduce the IAP of critical patients, shorten the time of feeding volume reaching the standard and reduce the incidence of FI.

Through the introduction of the gerontological nursing practice standards, the development course of practice, the scope of practice and gerontological nursing certification examination outline of American Nurses Credentialing Center in the US, the opinion about the development of gerontological nursing practice in our country is proposed. It is necessary to accelerate the cultivation of geriatric specialist nursing talent, and establishment of the scope and standards of gerontological nursing practice and geriatric specialized nurse certification system to cope with the development of aging society and improve gerontological nursing professional level in our country.