Abstract:Objective:To explore the effect of childlike nursing combined with positive psychological incentive in children with leukemia.Methods:All 78 cases of leukemia children and their caregivers who met the inclusion criteria from January 2023 to January 2024 were selected as the research objects,and randomly divided into observation group and control group,with 39 cases in each group.The children in the control group received routine nursing,while the children in the observation group received childlike nursing combined with positive psychological encouragement.Both groups were cared for for 4 weeks.The fatigue degree,emotional state,caregivers' cognition and hope level of the two groups were compared before and after intervention.Results:After the intervention,the scores of fatigue,cognition and rest dimensions,children's anxiety disorder screening scale(SCARED)and children's depression disorder self—rating scale(DSRSC)in the observation group were significantly lower than those in the control group(P＜0.05).The leuke-mia cognition situation and the level of hope of caregivers in the observation group were higher than those in the control group.The incidence of crying conflict and anorexia in the observation group was lower than that in the control group(P＜0.05).There was no significant difference in the incidence of nausea and vomiting,fatigue and fever between the two groups(P＞0.05).Conclusion:The application of childlike nursing combined with positive psychological encour-agement in children with leukemia not only helps to reduce the fatigue and discomfort symptoms of chemotherapy,but also improves the cognitive level and hope level of caregivers,which has a positive impact on improving the cooperation between nurses and patients and ensuring the smooth development of nursing work.

Abstract:Objective:Based on self—determination theory,this study explored the mediating effect of nursing infor-mation use behavior and job prosperity on job satisfaction and retention intention of acute critical care nurses.Methods:Convenience sampling method was used to investigate the 135 emergency and intensive care unit(ICU)nurses in Nanhua Hospital Affiliated to Nanhua University in hengyang city from August 2024 to October 2024.General data question-naire,job satisfaction scale,retention intention scale,nursing information system use behavior scale and job prosperity scale were used to collect data.Results:The results showed that job satisfaction,nursing information system use behav-ior,job prosperity and retention intention were positively correlated(P＜0.01),and job satisfaction,nursing informa-tion system use behavior and job prosperity all had a direct predictive effect on retention intention(P＜0.01).Job satis-faction can also be mediated by nursing information system use behavior and job prosperity,and the mediating effect ac-counts for 41.49％of the total effect.Conclusion:Nursing managers should pay attention to the needs of emergency and ICU nurses,and improve the job satisfaction and retention intention of acute and critical care nurses through incentive means.

Abstract:Objective:To investigate the clinicopathological features,immunophenotype,diagnosis and differential diagnosis of adult T—cell leukemia/lymphoma(ATLL).Methods:The clinicopathological data of 2 cases of ATLL with lymph node enlargement as the first symptom were analyzed retrospectively,and the lymph node biopsy was exam-ined by immunohistochemical(SP)method,and the related literature was reviewed.Results:Case 1 was male,46 years old;case 2 was female,84 years old.The specimens were all biopsy of lymph node enlargement.Lymph node structure was destroyed under the microscope,and the tumor was composed of single medium lymphoid cells,with abundant red cytoplasm,round oval,clear nucleoli,and few background reactive cells.Immunohistochemical staining showed positive expression of CD4 in tumor cells and positive expression of c—myc in tumor nuclei.ki—67 proliferation index was 80％,case 2 tumor cells weak expression of CD43 and CD45,and CD2,CD3,CD5,CD7,CD8,CD10,CD19,CD20,CD21,CD23,CD30,CD56,CD38,CD138,CD34,CD45RO,CD79a,CD99,CD117,CD1a,TDT,BCL—2,BCL—6,and MUM—1 were all negative,EBER negative.Conclusion:Lymphoma—type adult T—cell leukemia/lymphoma is rare,and the diag-nosis should be combined with clinical features,histopathological morphology and immunophenotype.In pathological di-agnosis,special attention should be paid to the differentiation from T—lymphoblastic lymphoma/leukemia,T—cell pre—lymphoblastic leukemia and non—specific peripheral T—cell lymphoma.

Abstract:Objective:In view of the problems of single patient application channel,cumbersome reimbursement process,time—consuming prescription review,difficult medication supervision and other problems in the traditional'two—channel'drug hospital management mode of medical insurance,explore the construction of a two—channel drug whole—process management system in hospital medical insurance,aiming at optimizing the application efficiency and strengthening the whole—process supervision ability.Methods:Based on the policy requirements and the actual needs of the hospital,the hospital hospital information system(HIS)system was integrated by information technology,and the closed—loop management system of application,review,circulation,supervision and quality improvement was designed.Use blockchain technology to ensure data security,introduce intelligent audit rules,improve application efficiency,serv-ice quality,and standardize the rationality of drug use.Results:After the system was launched,the time from application to drug purchase was reduced to less than 30 minutes,the average prescription circulation time was less than 1 minute,and the qualified prescription accuracy was increased by more than 90％.Audit efficiency was improved to 99.4％,and patient satisfaction increased to 98％.Conclusion:The whole process management system of two—channel prescription circulation in hospital medical insurance significantly improves the efficiency of application,review and service efficien-cy.In the future,it is necessary to further strengthen cross—institutional data interoperability,improve the risk preven-tion and control mechanism,and promote the application of the 'dual channel' model in a wider range.

Abstract:Objective:To explore the effects of handshake combined with informational support provided before an-esthesia induction on physiological and psychological states as well as nursing satisfaction among patients undergoing laparoscopic cholecystectomy.Methods:Eighty—four patients undergoing laparoscopic cholecystectomy in hepatobiliary surgery were enrolled by convenient sampling method,and the patients were divided into control group and observation group according to random number table method,with 42 cases in each group.Patients in the control group were given routine surgical care,while patients in the observation group were supported by visiting nurses who shook hands before anesthesia induction on the basis of routine care.The physiological indexes,psychological indexes and nursing satisfac-tion before anesthesia induction were compared between the two groups.Results:There were no significant differences between groups in systolic and diastolic blood pressures measured preoperatively and prior to anesthesia induction(P＞0.05).However,significant differences in heart rate prior to anesthesia induction were observed between groups(P＜0.05).Anxiety scores before anesthesia induction were significantly lower in the observation group compared to the control group(P＜0.05).Furthermore,nursing satisfaction scores were significantly higher in the observation group compared to the control group(P＜0.05).Conclusion:Implementing handshake and informational support prior to an-esthesia induction effectively reduces preoperative and induction—related stress,alleviates anxiety and tension,and en-hances surgical comfort and patient satisfaction with nursing care.

Abstract:Objective:To explore the efficacy and safety of domestic programmed cell death protein 1(PD—1)inhib-itors in advanced non—small cell lung cancer(NSCLC),and horizontally compare whether there are differences in the efficacy and safety of the three domestic PD—1 inhibitors.Methods:Sixty—one patients diagnosed with advanced non—small cell lung cancer and treated with domestic PD—1 inhibitors at Ulanqab Center Hospital from January 1 in 2020 to December 31 in 2023 were selected and divided into the tislelizumab group,the sintilimab group,and camrelizumab group according to the difference of the combination of immunocheckpoint inhibitors,and were followed up for more than 12 months to observe the treatment status of patients treated with domestic PD—1 inhibitors for advanced non—small cell lung cancer patients treated with domestically produced PD—1 inhibitors,and to cross—sectionally compare whether there are differences in efficacy,survival status and drug safety among the three groups.Results:In 61 patients with advanced NSCLC who received domestic PD—1 inhibitors,the objective remission rate(ORR)was 47.5％and the disease control rate(IDCR)was 93.4％,the progression—free survival(PFS)was(18.44+10.52)months,and the o-verall survival(OS)was(26.31+11.74)months,of which 70.5％were PFS over 12 months and 75.4％OS over 12 months.There was no statistically significant difference between the three immune checkpoint inhibitors,tislelizumab,sintilimab and camrelizumab,in terms of treatment outcome and survival in patients with advanced NSCLC.Various irAEs such as fatigue,hypothyroidism,immune pneumonitis,and capillary hyperplasia occurred after immunotherapy,and there was no statistically significant difference in the incidence of adverse reactions except for capillary hyperplasia,which was a Camrelizumab—specific adverse reaction.The incidence of all types of irAEs amounted to 68.8％,of which grade Ⅲ～Ⅳ accounted for 8.2％.Conclusion:Regardless of the number of lines of treatment,the efficacy and survival of patients with advanced NSCLC who received domestic PD—1 inhibitors in combination with chemotherapy were pro-longed compared with chemotherapy alone,and the domestic PD—1 inhibitors were more in line with the situation of the national population,and the price was suitable,and the immune—related adverse reactions were manageable and controllable.

Abstract:Objective:To explore the factors affecting the severity of oral and maxillofacial space infection(OMSI),and to find laboratory indicators with diagnostic and predictive value.Methods:A total of 336 OMSI patients in the de-partment of stomatology in fenyang hospital of shanxi from January 2016 to December 2021 were selected as the re-search objects,and clinical data were accessed through the electronic medical record system,and the database was sorted out and established.Univariate and multivariate analysis methods were used to analyze the influencing factors of OMSI severity,and receiver operating characteristic curve was used to predict the diagnostic value of meaningful laboratory in-dicators.Results:The factors affecting the severity of oral and maxillofacial space infection were as follows:age,diabe-tes mellitus,site of infection c(parapharyngeal,retropharyngeal and pretracheal space),white blood cell count(WBC),neutrophil absolute value(NEUT),C—reactive protein(CRP),procalcitonin(PCT)and fibrinogen(Fg)(P＜0.05),Among them,WBC,NEUT,CRP,PCT and Fg have good diagnostic and predictive value for disease severity.Conclu-sion:There are many factors affecting the severity of oral and maxillofacial space infection.Timely and effective diagno-sis and prediction can provide references for clinical diagnosis and treatment,so as to reduce the incidence of adverse outcomes.

Abstract:Objective:To explore the influence of dynamic nutritional support strategy based on acute gastrointesti-nal injury classification on nutritional status and traumatic stress level of elderly patients after transcatheter arterial chemoembolization(TACE).Methods:All 123 elderly patients with primary liver cancer who underwent TACE in Xinxiang Central Hospital from July 2021 to July 2023 were randomly divided into observation group(n=62 cases)and control group(61 cases).The control group was given conventional nutrition support,and the observation group was given dynamic nutrition support strategy of acute gastrointestinal injury classification.The nutritional status,traumatic stress level,liver function indexes and adverse reactions of the two groups were compared before and after nutritional support intervention.Results:The levels of hemoglobin(Hb),prealbumin(PA)and total protein(TP)in the observa-tion group were higher than those in the control group after intervention,with statistically significant differences(P＜0.05).After intervention,the levels of serum cortisol(Cor),aldosterone(ALD),norepinephrine(NE),tumor necrosis factor—α(TNF—α)and interleukin—6(IL—6)in observation group were lower than those in control group,with sta-tistically significant differences(P＜0.05).The levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP)in observation group were lower than those in control group after nutritional sup-port intervention(P＜0.05).The incidence of adverse reactions in observation group was lower than that in control group(P＜0.05).Conclusion:Dynamic nutrition support strategy based on acute gastrointestinal injury classification can improve nutritional status and traumatic stress level after TACE in elderly primary liver cancer,and reduce the risk of adverse reactions.

Abstract:Objective:To explore the application effect of wrist ankle acupuncture combined with acupoint applica-tion nursing for patients undergoing radical lung cancer surgery.Methods:A total of 80 patients who underwent radical lung cancer surgery in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from January to December in 2023 were selected.They were randomly divided into two groups using a random number table method,40 cases in each group.The control group was treated with wrist—ankle acupuncture,while the observation group was treated with wrist—ankle acupuncture combined with acupoint application.The immune function and the score of visual analogue scale(V AS),cancerous fatigue scale(CFS),Pittsburgh sleep quality index scale(PSQI),and cancer patient quality of life scale(EORTCQLQ—C30)were compared between the two groups.Results:Before treatment,there was no significant difference between the two groups in VAS score,immune function and CFS score,PSQI score and EORTCQLQ—C30 score(P＞0.05).After treatment,the scores of CD4+,CD4+/CD8+and EORTCQLQ—C30 in the two groups were higher than those before treatment,and the observation group was higher than the control group.After treatment,the VAS score,CFS score,PSQI score and CD8+in the two groups were lower than those before treatment,and and the observation group was lower than the control group,the difference was statistically significant(P＜0.05).Conclusion:Postoperative care of lung cancer patients using wrist and ankle acupuncture combined with acupoint appli-cation can significantly enhance the body's immunity and improve sleep quality.

Abstract:Objective:To explore the effects of high—intensity aerobic intermittent exercise combined with dual—heart intervention on changes in reactive oxygen metabolites(d—ROM)in elderly patients with chronic ejection frac-tion—preserved heart failure.Methods:From July 2021 to July 2023,90 elderly patients with chronic heart failure with preserved ejection fraction were selected and divided into control group and observation group according to random table method,with 45 cases in each group.The control group was given high—intensity aerobic interval exercise plus routine intervention,while the observation group was given high—intensity aerobic interval exercise plus double—hearted inter-vention.Cardiac function indexes,d—ROM changes and quality of life were observed in the two groups.Results:Before intervention,there was no statistically significant difference in the levels of high—sensitivity cardiac troponin T(hs—cTnT),N—terminal B—type natriuretic peptide precursor(NT—proBNP),left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),as well as emotional,cognitive,role,social,and physical function scores between the two groups(P＞0.05).The levels of hs—cTnT,NT—proBNP,LVEDD and d—ROM in the two groups were lower than those before the intervention,and the observation group was lower than the control group,the difference was statistically significant(P＜0.05).After the intervention,the hs—cTnT in the two groups was lower than that before the intervention,and that in the observation group was lower than that in the control group,with sta-tistical significance(P＜0.05).Conclusion:The combination of high—intensity aerobic intermittent exercise and dual—heart intervention can improve cardiac function in elderly patients with chronic ejection fraction—preserved heart fail-ure,reduce the impact on d—ROM,and improve the quality of life.

Abstract:Objective:To investigate the effect of cardiac troponin T( cTnT)and heart colour to exceed its significance in evaluating the prognosis of acute pulmonary embolism,and timely and accurate diagnosis and treatment of patients with pulmo-nary embolism,to improve the prognosis of patients and improve the survival rate. Methods:52 cases with pulmonary embolism between January 2010 in December 2013 by our institute of respiratory diseases diagnosis of,all of the patients in the hospital after electrocardiogram( ECG),myocardial troponin( cTnT)and heart colour to exceed check,the data to evaluate the clinical value in prognosis of acute pulmonary embolism. Results:The ECG in acute pulmonary embolism without important clinical val-ue in the evaluation of prognosis. supersonic and enchanted the graph is observed end—diastolic right ventricular diameter in-creased pulmonary embolism risk factor for severe or life—threatening complications,pulmonary artery pressure was not found is important index for prognosis of pulmonary embolism. Positive and negative patients right heart function obstacle massive pul-monary embolism were significant difference of serious complications,multiple regression analysis showed that positive troponin T is pulmonary embolism risk index of the severe complications. Conclusion:Right heart function is one of the important param-eters determine the prognosis of acute pulmonary embolism,the detection of right heart function is through the heart colour to exceed to reflect the prognosis of acute pulmonary embolism. Right heart function to a certain extent,related to the cardiac tro-ponin T,can evaluate the prognosis of acute pulmonary embolism. Electrocardiogram( ecg)in the right reaction specificity on heart function is poor,little clinical value to assess the prognosis of acute pulmonary embolism.

Abstract:Objective:Bydetectingosteoporoticbonemetabolismmarkersafterthebreak,tofindoutthecorrelationbe-tween bone metabolism makers and osteoporotic fractures in the elderly people. Methods:Senventy-eight cases of elderly pa-tients with osteoporotic fractures and 69 cases of elderly without fractures were as research subjects,whose serum bone-specif-ic alkaline phosphatase(B-ALP),osteocalcin(BGP),procollagen typeI N-terminal propeptide(PINP),tartrate-resistant acid phosphatase( TRACP)and urine pyridinoline( PYD),active C-telopeptide of collagen typeⅠ( CTX)were determined. Results:Biochemical markers of bone metabolism in elderly osteoporotic fracture patients aged above were significantly higher than the control group in B-ALP,BGP,PINP,TRACP5b,PYD,CTX(P﹤0. 05). Bone mineral density in patients with osteo-porosis were negatively correlated with B-ALP,BGP,PINP,TRACP5b,PYD,CTX scores(P﹤0. 05),which has a statistical significance. Conclusion:There was correlation between osteoporotic fractures and biochemical markers. It shortened the healing time for the clinical treatment of osteoporotic fractures and reduces recurrent fractures providing a theoretical basis.