Abstract:Objective:To retrieve,evaluate,and summarize the best evidence for the prevention and management of extrauterine growth restriction(EUGR)in preterm infants worldwide,so as to provide theoretical support and practical guidance for clinical practice.Methods:Literature on the prevention and management of EUGR in preterm infants was systematically retrieved from domestic and international databases,guideline websites,and professional websites,including clinical decisions,evidence-based practice,guidelines,evidence summaries,systematic reviews,Meta-analyses,and expert consensuses retardation.The search period was from the inception to January 15,2025.Two researchers independently assessed the quality of the literature,extracted evidence,and summarized it using uniform standards.Results:A total of 19 articles were included,including 2 clinical decision-making articles,4 guideline articles,6 expert consensus articles,5 systematic reviews,and 2 evidence summaries.A total of 38 pieces of best evidence were summarized from 6 aspects:risk factor identification for EUGR in preterm infants,parenteral nutrition support,enteral nutrition support,promotion of oral feeding,developmental support care,and follow-up management.Conclusions:Current evidence shows that the summarized best evidence for the prevention and management of EUGR in preterm infants can provide evidence-based support for healthcare professionals.In clinical practice,targeted and standardized interventions should be adopted according to the specific conditions and clinical scenarios of preterm infants,so as to reduce the risk of extrauterine growth restriction(EUGR)and improve the long-term quality of life of preterm infants.

Abstract:Objective:To construct a predictive model for the risk of low cardiac output syndrome(LCOS)after heart valve replacement(HVR)based on the decision tree method.Methods:A total of 260 patients who underwent HVR surgery in our hospital from June 1,2023 to June 30,2025 were selected as the study subjects and divided into a control group(n=213)and an LCOS group(n=47)according to the postoperative LCOS occurrence.Logistic regression analysis was used to analyze the influencing factors of LCOS after HVR surgery,a decision risk prediction model was established,and area under the receiver operating characteristic(ROC)curves were plotted to evaluate its predictive efficacy.Results:A total of 47 of the 260 patients who underwent HVR surgery developed LCOS postoperatively,with an incidence rate of 18.08%.Logistic regression analysis showed that age,body mass index(BMI),electrolyte imbalance,intraoperative blood loss≥20%,cardiopulmonary bypass(CPB)time,and aortic cross-clamp(ACC)time were risk factors for LCOS after HVR surgery(P<0.05).A decision tree model constructed based on these risk factors consisted of 3 layers,15 nodes,and 8 terminal nodes,with intraoperative blood loss as the first layer,indicating that intraoperative blood loss was the most important influencing factor.ROC curve results showed that the AUC of the decision tree model(0.901)was higher than that of the Logistic regression model(0.852),and the difference was statistically significant(Z=2.019,P=0.043).Conclusions:The occurrence of LCOS after HVR surgery is influenced by multiple factors.The risk prediction model for LCOS after HVR surgery constructed based on influencing factors has good predictive efficacy which can provide a basis for clinicians to identify high-risk patients early.

Abstract:Objective:To systematically evaluate the efficacy and safety of comprehensive nursing practice(CNP)and traditional nursing practice(TNP)in the clinical nursing of children undergoing laparoscopic appendectomy(LA).Methods:Relevant literature on the comparative application of CNP and TNP in the clinical nursing of children undergoing LA was retrieved from PubMed,Cochrane Library,Web of Science,CNKI,VIP,and WanFang Data.The retrieval time was from January 1,2015 to May 25,2025.The Newcastle-Ottawa Scale(NOS)was used to assess the quality of the included studies.The RevMan 5.4.1 software was used for data analysis.Results:A total of 29 retrospective cohort studies involving 2 914 patients were included.All included literature had a NOS score≥7.Meta-analysis results showed that the experimental group had shorter times to first flatus,first defecation,first ambulation,and length of hospital stay compared to the control group;lower incidence of adverse reactions,irritability,and hospitalization costs compared to the control group;and higher parental satisfaction with nursing care compared to the control group,the differences were all statistically significant(P<0.05).Conclusions:In the clinical nursing of children undergoing LA,CNP has multidimensional advantages over TNP in terms of safety and efficacy.