Abstract:Objective To analyze the effect of hierarchical nursing intervention based on the Cox proportional hazards regression model on postoperative rebleeding in patients with hypertensive intracerebral hemorrhage(HICH).Methods A total of 136 HICH patients admitted to Kunshan Traditional Chinese Medicine Hospital from January 2021 to June 2023 were selected as the modeling cohort.Independent risk factors for postoperative rebleeding were identified using univariate and multivariate Cox proportional hazards regression models.An individualized risk scoring system was constructed for risk stratification.Subsequently,82 HICH surgical patients admitted between July 2023 and November 2024 were enrolled as the validation cohort and randomly assigned(using a random number table)to either a control group(n=41,receiving conventional nursing)or an observation group(n=41,receiving hierarchical nursing based on the Cox proportional hazards regression model).Blood pressure control immediately postoperative and within 12 hours postoperatively,rebleeding rate within 7 days postoperatively,neurological function(National Institutes of Health Stroke Scale(NIHSS)score)and incidence of complications during the intervention were compared between the two groups.Results Cox regression analysis identified age,hematoma volume,presence of underlying diseases,and postoperative blood pressure as independent risk factors for postoperative rebleeding(P<0.05).No significant difference in immediate postoperative blood pressure was found between groups(P>0.05).The peak blood pressure and fluctuation amplitude within 12 hours postoperatively were significantly lower in the observation group compared to the control group(P<0.05).The rebleeding rate within 7 days postoperatively was significantly lower in the observation group(2.44%)than in the control group(17.07%)(P<0.05).NIHSS scores decreased significantly in both groups 2 weeks after intervention,with lower scores in the observation group(P<0.05).The complication incidence was significantly lower in the observation group(4.88%)than in the control group(19.52%)(P<0.05).Conclusions The hierarchical nursing intervention system,constructed based on the Cox proportional hazards model,utilizes dynamic risk stratification integrating four independent risk factors(age,hematoma volume,underlying diseases,and postoperative blood pressure).This system significantly optimizes blood pressure control precision in HICH surgical patients,markedly reduces the incidence of postoperative rebleeding,effectively promotes neurological functional recovery,and decreases complications rate.

Abstract:Objective To explore the application of curriculum ideological and political education in the course of Otorhinolaryngology-Head and Neck Surgery and the evaluation of its teaching effect.Methods A total of 186 students from the 1st to 4th classes of the Clinical Medicine major of Wannan Medical College,2020 grade,were randomly divided into experimental group(n=96)and control group(n=90).The control group adopted the traditional teaching mode,while the experimental group integrated curriculum ideological and political education into the teaching of Otorhinolaryngology-Head and Neck Surgery.The academic performance,recognition of curriculum ideological and political education,and satisfaction evaluation of the teaching effect were compared between the two groups.Results The score of basic medical knowledge in the experimental group((80.24±8.74)points)was higher than that in the control group((75.09±9.57)points),and the score of professional practice ability((39.75±5.01)points)was higher than that in the control group((35.88±4.37)points)(all P<0.05).There was a significant difference in the recognition of curriculum ideological and political education between the two groups(P<0.05).The students in the experimental group were more satisfied with the course teaching than those in the control group(P<0.05).Conclusions The integration of curriculum ideological and political education into Otorhinolaryngology-Head and Neck Surgery can improve students'political literacy and professional ethics,and lay a solid foundation for cultivating all-round medical talents.

Abstract:Objective To explore the mediating effect of perceived spouse support on the quality of two-way communication and family flexibility in gynecological cancer patients.Methods One hundred and forty-eight gynecological cancer patients from May 2021 to December 2023 were selected by convenience sampling method,and the perceived spouse support level was evaluated by Support in Intimate Relationships Rating Scale(SIRRS).The simplified Chinese version of Family Flexibility Rating Scale(FRAS-C)was used to evaluate the family flexibility of patients.The quality of two-way communication was evaluated by the marital communication quality scale of gynecological cancer patients.Pearson correlation software was selected to calculate the coefficient between different variables,construct the structural equation,and determine whether the intermediary effect existed after data fitting.Results Women with gynecological cancer had the highest SIRRS score(31.24±4.42)points.The score of family communication and problem solving in FRAS-C scale was(72.59±6.31)points;the two-way communication quality score was the highest in stress coping and normalcy creation.The correlation results showed that SIRRS scale was negatively correlated with FRAS-C scale and bidirectional communication quality scale(P<0.05).In family flexibility,family communication and problem solving,using social resources and holding positive views were negatively correlated with the quality of two-way communication(P<0.05).The structural equation model results show that the 95%confidence interval of two-way communication quality on family flexibility is(0.045,2.041),and two-way communication quality affects family elasticity mainly through the mediating effect of perceived spousal-supported intimate relationship.Conclusions Patients with gynecological cancer have low level of two-way communication,average perceived spousal support,and poor family flexibility,and structural equation model results indicate that two-way communication quality can indirectly predict family flexibility through perceived spousal support.

Abstract:This article summarized the surgical nursing experience of extracorporeal membrane oxygenation(ECMO)treatment in 5 cases of sudden cardiac shock after off-pump coronary artery bypass grafting.Before surgery,nurses should visit patients to understand the patient's condition,surgical preparation status,and contingency plan,while ensuring sufficient preparation of supplies and surgical room;During surgery,exquisite nursing techniques,skilled surgical coordination,and ECMO care(including posture and skin care,temperature management,autologous blood recovery technology,establishment of ECMO pipelines,operation of hosts,monitoring of pipeline blood flow,and precise volume management)are essential.After surgery,safe transportation,pipeline protection,and detailed patient handover are important guarantees for the success of the surgery.

Abstract:Objective To construct a post competency index system for fever clinic nurses based on the infectious disease outbreaks,so as to provide a comprehensive,systematic and quantifiable standard for responding to infectious disease outbreaks and deploying nurses with corresponding post competencies in fever clinics.Methods Literature review,semi-structured interviews,and Delphi expert consultation were adopted to evaluate the professional capabilities of fever clinic nurses,and the analytic hierarchy process(AHP)was used to calculate the weight of each index.Results The effective recovery rate of the two rounds of questionnaires was 100%.For the two rounds of consultations,the coefficient of judgment basis of nursing experts was 0.900,the familiarity coefficient was 0.893,and the authority coefficient was 0.897.Kendall's coefficient of concordance for the first-level,second-level and third-level indicators in the second round of consultation was 0.400,0.399 and 0.414,respectively(P<0.001).Finally,a comprehensive index system consisting of 4 first-level indicators,14 second-level indicators and 57 third-level indicators was established.Conclusions The post competency index system for nurses in fever clinic is scientific,reliable and targeted,which could provide strong support for the training,talent selection and performance management of fever clinic nurses.

Abstract:Objective To explore the effectiveness of behavior-oriented teaching mode in community nursing education.Methods A total of 118 students from the 2021 grade of the nursing major in Nantong Health Vocational College and Technical School were randomly selected,among which 58 nursing students in one class were assigned to the control group and received conventional teaching mode,while 60 nursing students in the other class were assigned to the research group and received behavior-oriented teaching mode.The course grades,teaching effect evaluation and teaching satisfaction of the two groups were compared.Results The course scores,evaluation of teaching effectiveness and teaching satisfaction of nursing students of the research group were all higher than those of the control group(all P<0.05).Conclusions The application effect of behavior-oriented teaching mode demonstrates good effectiveness in community nursing education,which helps improve teaching quality and enhances the autonomous learning ability of nursing students,and enables nursing students to master community nursing knowledge and practical skills more effectively.

Abstract:The article summarizes the nursing experience of a patient with multiple myeloma who developed cytokine release syndrome after chimeric antigen receptor T cells(CAR-T)treatment with duble plasma molecular adsorption system(DPMAS).Key nursing points include anticoagulation management during DPMAS treatment,patient condition monitoring and instrument operation management during DPMAS treatment,nursing of temporary hemodialysis catheters,prevention and management of related complications during DPMAS treatment,and psychological care for the patient.After careful treatment and care,the patient recovered well and was transferred to a general ward for further treatment.

Abstract:Objective To summarize the nursing experience of implementing urination function training in elderly high-risk patients with benign prostatic hyperplasia(BPH)after stent placement.Methods Elderly high-risk BPH patients who underwent spiral thermal expansion stent placement at the Department of Urology,Jiangsu Provincial Official Hospital,from January 1,2023,to August 31,2024,were selected as the study subjects.Individualized urination function training was provided postoperatively.Clinical data were collected and analyzed to summarize the training methods and nursing experience that promote the recovery of urination function after surgery.Results A total of 30 patients,with a mean age of(83.73±6.83)years,were included.All patients regained spontaneous urination after combined urination training.The bladder fistula tube sealing time was(6.20±2.98)days,the bladder fistula tube removal time was(11.23±4.20)days,and the urination function grade was 0 to Ⅰ.Conclusions For elderly high-risk BPH patients undergoing stent placement,individualized urination training implemented by nurses postoperatively is conducive to the early restoration of spontaneous urination.

Abstract:To summarize the nursing experience of a patient with duodenal stasis with indwelling triple-lumen jejunal nutrition tube for enteral nutrition.Multi-directional nursing care was carried out for jejunal nutrition tube via evaluating the nutritional status of patients,including disease and tolerance assessment,nutritional assessment,enteral nutrition care,oral and nasal care,skin care,psychological care and complications care.Through the implementation of multidisciplinary collaboration after more than seven months of care,the patient's nutritional status and discomfort symptoms were improved,with no related complications occurring and body weight increased.The angle of the superior mesenteric artery resumed normal,and the patient was discharged withsymptom relief.

Abstract:Objective Based on the"Four Joys"Classroom,this study implemented the teaching practice of curriculum ideological and political education(CIE)in Nursing English courses through an embedded and progressive approach,aiming to leverage the educational role of professional courses.Methods We explored the embedded and progressive CIE model for the Nursing English course based on the"Four Joys"Classroom.We created a high-quality teaching team,promoted the integration of in-class and extracurricular teaching,constructed a progressive teaching framework featuring the"Three-Stage and Three-Emotion"mode,and constructed a five-dimensional CIE teaching model.Teaching effectiveness was evaluated through supervision from university experts,and peer observation and review.Results Students agreed that the teachers paid attention to their moral education and integrated the classroom into the ideological and political performance,and the supervision and peer evaluation were good.Conclusions The embedded and progressive CIE model for Nursing English course based on the"Four Joys"Classroom is conducive to improving students'ideological and political literacy and teaching effectiveness.

Abstract:Objective To evaluate the application effect of family-centered positive behavior support(FPBS)combined with appreciation motivation technique in preschool children with epilepsy.Methods A total of 80 preschool children with epilepsy admitted to Zhanjiang Central People's Hospital from January 2023 to December 2024 were selected and randomly assigned to either the experimental group(n=40)or the control group(n=40).The control group received routine nursing care for children with epilepsy,while the experimental group received FPBS combined with appreciation and motivation techniques intervention.The two groups were compared in terms of emotional and behavioral problems(strengths and difficulties questionnaire,SDQ),treatment resistance,seizure control,and quality of life(ISLQ).Results The experimental group had lower SDQ scores,treatment resistance scores,and monthly average seizure frequency than the control group,while the ISLQ score was higher than the control group(all P<0.05).Conclusions The application of FPBS combined with appreciation and motivation techniques effectively reduces emotional disorders,behavioral problems,and treatment resistance,improves disease control effectiveness,and optimizes quality of life in children with epilepsy.

Abstract:The campus spirit,a shared cultural value cherished by faculty and students throughout the institution's long-standing development,plays a unique role in moral education and talent cultivation,endowing students with distinctive spiritual qualities.The refinement of campus spirit follows a"resources-story-spirit"progression."School-based cultural resources"represent the original cultural essence of the institution's developmental journey,while historical narratives serve as narrative vehicles for these resources,enabling the organic integration of school history memories,the fine traditions of its educational practice,and the educational demands of the times.Through the elevation of campus history stories,the"campus spirit"forms a unique identity that reflects the institution's cultural depth,historical traditions,and value pursuits.Leveraging over 90 years of medical education legacy,Jiangsu Health Vocational College has deeply explored its"school-based cultural resources",continuously enriching a series of"Five Aid Stories"that have nurtured the distinctive"Five Aid Spirit,"becoming a hallmark resource for moral education and talent development.

Abstract:Postherpetic neuralgia(PHN)is a common and complex complication,and the long-term pain caused by PHN can severely impact patients'quality of life.Nursing models,as an effective adjunctive intervention,are increasingly being applied in the treatment of PHN patients.This article reviewed the research progress of pain management pathways,the'four-in-one'nursing model,multidimensional collaborative nursing models,and other related approaches in the nursing care of PHN,aiming to provide a scientific basis and clinical reference for further improving the nursing management of PHN patients.

Abstract:Objective To investigate the influencing factors and nursing countermeasures of lower extremity deep venous thrombosis(DVT)after total joint replacement.Methods The convenience sampling method was used to select patients who underwent total joint replacement in the Second Affiliated Hospital of Chongqing Medical University from October 2022 to December 2023 as the study subjects.According to whether DVT occurred within 30 days after operation,they were divided into DVT group and non-DVT group.Generalized linear mixed model was used to analyze the influencing factors of DVT.Results A total of 106 patients were enrolled,including 30 patients in the DVT group,accounting for 28.3%,and 76 patients in the non-DVT group,accounting for 71.7%.Generalized linear mixed model analysis showed that age(OR=1.110,95%CI(1.030-1.198),P=0.007),Charlson score(OR=1.650,95%CI(1.140-2.390),P=0.009),postoperative bed rest time(d)(OR=1.161,95%CI(1.016-1.393),P=0.040),postoperative pharmacologic prophylaxis initiation time(h)(OR=1.012,95%CI(1.003-1.021),P=0.046),and postoperative mechanical prophylaxis initiation time(h)(OR=1.027,95%CI(1.005-1.056),P=0.037)are factors influencing lower extremity deep vein thrombosis after total joint replacement.Conclusions Clinical medical staff should pay attention to the prevention and treatment of DVT in elderly patients and patients with multiple diseases,start mechanical prophylaxis and drug prevention as soon as possible,pay attention to the postoperative activity ability of patients,encourage and guide patients to get out of bed early,and flexibly formulate personalized prevention and treatment programs to avoid the occurrence of DVT,so as to improve the prognosis.

Abstract:Objective To investigate the risk of adverse outcomes(hypoglycemia,hospitalization,death,and decline in quality of life)in older patients with type 2 diabetes mellitus(T2DM)based on health status stratification.Methods A prospective cohort study was conducted,enrolling 308 older T2DM patients from February 2022 to July 2022.According to the Chinese Guidelines for the Diagnosis and Treatment of Senile Diabetes(2021 edition),participants were stratified into good,intermediate,and poor health groups.Baseline data were collected,and prospective follow-up was performed.Kaplan-Meier survival analysis and Cox proportional hazards regression models were used to assess the association between health status stratification and adverse outcomes.Results Two hundred and seventy-seven patients completed a median follow-up of 6 months.Stratified by health status:101 cases(32.8%)in the good health group,164 cases(53.2%)in the moderate health group,and 43 cases(14.0%)in the poor health group.Significant differences were observed among the three groups in key baseline characteristics such as age,comorbidity count,cognitive function,and self-care ability(P<0.05).Multivariate Cox regression analysis showed that compared with the good health group,patients in the poor health group had significantly higher risks of hospitalization(HR=2.365,95%CI:1.078-5.193),hypoglycemia(HR=3.470,95%CI:1.430-8.419),and decline in quality of life(HR=2.082,95%CI:1.003-4.321).The risk of death in the poor health group also showed an increasing trend(HR=8.797,95%CI:0.655-118.073).Conclusions Health status stratification is an independent predictor of short-term adverse outcomes in older T2DM patients.Implementing a safety-oriented individualized management strategy for patients in poor health status may help improve their clinical outcomes.

Abstract:Objective To explore the impact of intraoperative position nursing on the short-term and long-term postoperative recovery of hypertensive patients undergoing hip arthroplasty.Methods A total of 116 hypertensive patients who underwent hip arthroplasty at Suzhou Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from February 2021 to August 2024 were collected.They were randomly divided into a control group(receiving routine nursing)and an observation group(receiving intraoperative position nursing intervention)using the random number table method,with 58 cases in each group.The surgical and postoperative indicators,incidence of complications,blood pressure fluctuations,and postoperative recovery status of the two groups were compared.Results The operation time,postoperative wound healing time,and postoperative visual analogue scale(VAS)score of patients in the observation group were(96.24±12.13)min,(5.19±1.29)d,and(3.82±1.21)points,respectively,which were superior to those of the control group((112.36±15.47)min,(7.69±2.02)d,and(5.75±1.75)points)(all P<0.05).The incidence of complications in the observation group was 6.90%,which was lower than that in the control group(27.59%).The blood pressure fluctuation amplitude of patients in the observation group 24 hours after surgery was(12.37±3.18)mmHg,which was lower than that of the control group((18.83±4.42)mmHg).The Barthel index scores of patients in the observation group 7 days,3 months,and 6 months after surgery were(84.23±8.22)points,(87.56±6.89)points,and(91.35±4.28)points,respectively,and the Harris hip function score 6 months after surgery was(89.62±5.37)points,all of those were higher than those of the control group((71.66±6.53)points,(76.32±7.15)points,(82.17±5.64)points,and(78.45±6.12)points)(all P<0.05).Conclusions Intraoperative position nursing can significantly improve the short-term postoperative recovery of hypertensive patients undergoing hip arthroplasty,reduce the incidence of complications,and have a positive effect on the long-term recovery of joint function and self-care ability.

Abstract:As an outstanding educator,educational thinker,and great communist fighter in China,Tao Xingzhi devoted his entire life to the cause of national liberation and people's freedom.He dedicated himself to the cause of education,making remarkable achievements and leaving a valuable spiritual legacy.On the occasion of the 80th anniversary of the victory of the War of Resistance Against Japanese Aggression and the World Anti-Fascist War,the author revisits Mr.Tao Xingzhi's patriotic life and his profoundly touching deeds of saving the country during the war,deeply analyzes the inherent connection between his educational thoughts and his anti-Japanese national salvation practice,and explores the contemporary enlightenment of his patriotic spirit.

Abstract:Objective To address the ambiguity of traditional verbal communication in robotic surgery by establishing a 3D coordinate system to enhance instrument transfer efficiency and team collaboration accuracy.Methods A prospective randomized controlled trial enrolled 80 patients who underwent Vinci robotic radical prostatectomy at Jiangnan University Affiliated Central Hospital between June 2023 and December 2024.Participants were assigned to an observation group(3D coordinate communication)or a control group(traditional communication).The observation group utilized the ureteral orifice as the coordinate origin to define zones(A:urethral anastomosis;B:neurovascular bundle;C:Denonvilliers'fascia),with standardized command format of Zone number+3D offset"and an emergency code system(Code α/β/γ).Nurses received 3D model training(error<0.3 cm),with quality control metrics were monitored.Results The observation group showed significantly shorter command response time(9.3±2.1)s vs.(68.2±15.4)s,higher first-pass instrument accuracy(98.5±1.3)%vs.(82.7±6.8)%,and reduced nurse stress score(32.6±8.4)vs.(71.3±12.6)points.Non-core time decreased(18.3±3.5)%vs.(34.7±6.9)%,and higher surgeon satisfaction scores(9.2±0.7)vs.(6.1±1.4)points,all P<0.001.Conclusions The 3D coordinate communication mode optimizes nursing efficacy in robotic surgery through standardized spatial positioning and procedural decision-making.

Abstract:This study summarizes the postoperative individualized pulmonary rehabilitation nursing practices for 12 patients with severe valvular heart disease(VHD)complicated by chronic obstructive pulmonary disease(COPD).A multidisciplinary team was established to develop a stepwise pulmonary rehabilitation protocol,which included:inspiratory muscle training combined with chest physiotherapy to prevent pulmonary complications;nutritional support and resistance training to improve sarcopenia;a progressive exercise program to enhance exercise tolerance;lung-protective ventilation strategies with step-down oxygen therapy for dynamic oxygenation support;standardized airway clearance techniques with air-driven nebulization to promote sputum excretion;transcutaneous carbon dioxide monitoring to establish a nocturnal respiratory surveillance system;personalized health education to improve self-management and treatment compliance and participation.After comprehensive intervention,all 12 patients achieved successful extubation,were transferred to general wards,and were discharged in stable condition.Three-month postoperative follow-up demonstrated sustained improvements in pulmonary function and exercise capacity,confirming the clinical value of individualized pulmonary rehabilitation in critically ill patients with comorbidities.

Abstract:Objective To explore the methods and evaluate the effectiveness of ideological and political education integrated into emergency rescue courses under the Paddle Class teaching model.Methods A total of 215 sophomore students majoring in Automotive Inspection and Maintenance Technology(2022 cohort)were selected as participants.Ideological and political education was incorporated into the emergency rescue curriculum using the Paddle Class approach.Based on course content,workplace scenarios,and student characteristics,ideological and political teaching objectives were formulated.This included integrating the Paddle Class model,organizing Red Cross volunteer activities,and utilizing online cloud-based teaching resources to establish a multi-dimensional educational framework combining in-class and extracurricular,on-campus and off-campus,and online and offline learning.Results Approximately 96.7%(208/215)of students rated the ideological and political teaching outcomes as"very satisfied".Theoretical scores averaged above 90 points,all students passed practical assessments,and all obtained the Primary First Aid Responder Certificate.98.1%of students expressed willingness to actively assist in emergencies.The emergency rescue course was awarded the 2021 National-Level Ideological and Political Education Demonstration Course,along with the"Teaching Excellence and Team"honorary title.In 2023,the institution was designated as a pilot school for the second batch of the National School Emergency Education Program.Conclusions The integration of ideological and political education into emergency rescue courses enhances non-medical students'willingness and competence in first aid,fosters a"life first"ethos and lifelong learning mindset,and achieves the goal of collaborative education.It also contributes to building high-quality emergency training instructor teams and strengthens institutional emergency management capabilities.