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Objective:The prediction model of feeding intolerance in preterm infants was established and validated to provide guidance for clinical practice.Methods:This was a case-control study. A retrospective analysis was conducted on 210 premature infants with gestational age less than 34 weeks from September 2022 to May 2023. They were divided into training and validation sets in a 1∶1 ratio. The univariate and multivariate binary Logistic regression analysis were performed on training set samples, first identified the risk factors for feeding intolerance occurrence, and established a premature feeding intolerance risk prediction model based on these risk factors. Visualized the model using a column chart. The performance of the model was evaluated using receiver operating characteristic (ROC) curves, calibration curves, and clinical decision curves in the training and validation sets, respectively. The ROC curve was used to evaluate the differentiation ability of the model, the calibration curve was used to evaluate the consistency of the model, and clinical decision-making was used to evaluate the net benefit status of patients when the model guides clinical interventions.Results:Among them, there were 84 cases in the feeding tolerance and 126 cases in the feeding intolerance. There were 53 males and 31 females with feeding tolerance aged (32.38 ± 1.37) weeks and 73 males and 53 females with feeding intolerance aged (30.01 ± 2.14) weeks. Through univariate Logistic regression analysis of 12 related variables, there were significant differences between the feeding tolerance premature infants and the feeding intolerance premature infants in 8 variables of premature birth weight, birth asphyxia, caffeine use, delayed defecation, gestational age, lactation time, non-invasive ventilation time, and invasive ventilation time ( OR values were 0.032-18.706, all P<0.05). Multiple Logistic regression ultimately screened out three variables, namely premature infant body mass, delayed defecation, and non-invasive ventilation time ( OR = 0.073, 4.926, 1.244, all P<0.05). The area under the ROC curve of the training and validation sets were 0.906 and 0.876, respectively. The calibration curves of the training and validation sets indicated that the model had high consistency. The Hosmer-Lemeshow goodness of fit test showed that χ2 = 7.92, P = 0.442. Conclusions:The prediction model established in this study has high discrimination, calibration, and clinical practical value, and can accurately predict the risk of feeding intolerance in premature infants, providing reference basis for timely nursing and clinical intervention.
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Objective:To explore the application effect of family-centered empowerment model (FCEM) in rehabilitation nursing of children with femoral shaft fractures treated by skin traction.Methods:A retrospective case-control study was conducted to analyze the clinical data of 107 children with femoral shaft fractures treated with skin traction in Anhui Children′s Hospital from April 2019 to October 2021, including 67 males and 40 females; aged 1.5-5.0 years [2.8(2.0, 3.5)years]. Fracture types included oblique fracture ( n=50), comminuted fracture ( n=26), transverse fracture ( n=14) and spiral fracture ( n=17). FCEM nursing was implemented in 55 patients (family empowerment group) and routine home rehabilitation nursing guidance was performed in 52 patients (routine nursing group). The face, legs, activity, cry, consolability (FLACC) behavioral score on admission and at days 1, 3 and 7 after skin traction, treatment compliance rate at 1 month after skin traction, complication rate at 1 month after skin traction, length of hospital stay and fracture healing time were compared between the two groups. Results:All patients were followed up for 12-18 weeks [13.4(12.7, 13.9)weeks]. There was no significant difference in FLACC behavioral score between the two groups on admission ( P>0.05). The FLACC behavioral score was (4.0±0.7)points,(3.4±0.6)points and (2.4±0.6)points in family empowerment group at days 1, 3 and 7 after skin traction, lower than (4.8±0.7)points, (3.9±0.8)points and (3.3±0.5)points in routine nursing groups (all Ρ<0.01). One month after skin traction, treatment compliance was excellent in 51 patients, good in 4, poor in 0, with treatment compliance rate of 92.7% (51/55) in family empowerment group, and was excellent in 40 patients, good in 9, poor in 3, with treatment compliance rate of 76.9% (40/52) in routine nursing group ( Ρ<0.05). The complication rate was 5.4% (3/55) in family empowerment group, lower than 21.2% (11/52) in routine nursing group ( Ρ<0.05). The length of hospital stay and fracture healing time were (15.6±0.3)days and (7.1±0.8)weeks in family empowerment group, shorter than (16.8±0.3)days and (8.2±0.4)weeks in routine nursing group (all Ρ<0.01). Conclusion:For children with femoral shaft fractures treated by skin traction, nursing using FCEM can alleviate pain, improve treatment compliance, reduce complication rate, reduce hospital stay and shorten fracture healing time.
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Methods:Two thousand standard sections images werre collected from 2 000 clinical retrospective pediatric hip ultrasound videos from January 2019 to January 2021. All standard sections were annotated by the annotation team through the self-designed software based on Python 3.6 environment for image cross-media data annotation and manual review standardization process with unified standards. Among them, 1 753 were randomly selected for training the deep learning system, and the remaining 247 were used for testing the system. Further, 200 standard sections were randomly selected from the test set, and 8 clinicians independently completed the film reading annotation. The 8 independent results were then compared with the AI results.Results:The testing set consists of 247 patients. Compared with the clinician's measurements, the area under the receiver operating characteristic curve (AUC) of diagnosing hip joint maturity was 0.865, the sensitivity was 76.19%, and the specificity was 96.9%. The AUC of AI system interpretation under Graf detailed typing was 0.575, the sensitivity was 25.90%, the specificity was 89.10%. The 95% LoA of α-angle determined by Bland-Altman method, of -4.7051° to 6.5948° ( Bias -0.94, P<0.001), compared with clinicians' measurements. The 95% LoA of β-angle, of -7.7191 to 6.8777 ( Bias -0.42, P=0.077). Compared with those from 8 clinicians, the results of AI system interpretation were more stable, and the β-angle effect was more prominent. Conclusion:The AI system can quickly and accurately measure the Graf correlation index of standard DDH ultrasonic standard diagnosis plane.
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Objective:To understand the degree of professional autonomy of nurses in Pediatric Nursing Alliance and the status of pediatric nursing practice environment, which providing guidance for the development of a series of specialized training in the alliance.Methods:Stratified random sampling method was used to conduct a questionnaire survey on nursing staff of different professional levels in Pediatric Nursing Alliance, which through the questionnaire star by using the questionnaire general information and training demand questionnaire, nurses practice professional autonomy scale, pediatric nursing staff structural empowerment questionnaire and nursing practice influencing factors questionnaire through the questionnaire star.Results:The total score for professional autonomy of nurses in the pediatric alliance was 192.66±18.63, the structural empowerment ( OR=1.137, 95% CI=1.084-1.194), lack of caring team ( OR=2.763, 95% CI=1.443-5.292) and performance evaluation ( OR=0.498, 95% CI= 0.274-0.908), specialized education and professional experience ( OR=0.548, 95% CI= 0.334-0.871) were affecting the clinical nursing practice. Conclusion:The degree of professional autonomy of nurses in the Pediatric Nursing Alliance is in the middle and high level. Key factors affecting nursing practice including insufficient structural empowerment, lack of opportunities to continue learning, lack of nursing teams, lack of effectiveness evaluation and the lack of specialized education and work experience, which guiding the pediatric nursing alliance to continuously deepen the connotation of pediatric nursing professional and innovative team collaboration new model, utilize the advantages of resources to actively cultivate specialized nursing research personnel, carry out multi-disciplinary and cross-disciplinary cooperation, improve the nursing quality evaluation index system, so as to enhance the professional nursing service capacity and value.
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Objective To investigate the effect of ultrasound transdermal delivery in children with swelling and pain after supracondylar fracture of the humerus. Methods Totally 103 cases of humeral supracondylar fractures from January to June 2017 were divided into control group (50 cases) and experimental group (53 cases) by random number table method. The control group was treated with conventional detumescence and intravenous drug therapy,while the experimental group was given the local target ultrasonic percutaneous delivery in accordance with the doctor′s advice on the basis of routine treatment. By comparing the two groups in terms of postoperative pain, swelling relief, starting time for getting out of bed, hospitalization time, and parental satisfaction of children, we investigated the effect of ultrasonic ultrasound transdermal delivery on children with swelling and analgesia after supracondylar fracture of the humerus. ResuLts Postoperative pain relief and swelling relief were significantly reduced in the experimental group compared with the control group, and the difference between the two groups was statistically significant (P＜0.05).The time of starting to get out of bed activity and hospitalization were respectively (8.20 ± 0.25) hours and (5.12 ± 0.27) days, and the control group was (23.80 ± 0.15) hours, (7.35 ± 0.38) days, respectively.The comparison was statistically significant (t=24.241, 7.654, all P＜0.05). The parents'satisfaction in the experimental group was very satisfied, relatively satisfied, basically satisfied and unsatisfied, respectively 88.68% (47/53), 7.55% (4/53), 3.77% (2/53), 0, the control group was 64.00% (32/50), 26.00% (13/50), 10.00% (5/50), 0(0/50), the difference between the two groups was statistically significant ( χ2=5.294 2, P＜0.05). ConcLusions The accuracy of ultrasonic percutaneous local target placement for the treatment of supracondylar fractures of the humerus in children is effective in the intervention of pain and swelling, and the comfort is better. It is a new choice for the treatment of limb fractures with pain in children.
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Objective@#To investigate the effect of ultrasound transdermal delivery in children with swelling and pain after supracondylar fracture of the humerus.@*Methods@#Totally 103 cases of humeral supracondylar fractures from January to June 2017 were divided into control group (50 cases) and experimental group (53 cases) by random number table method. The control group was treated with conventional detumescence and intravenous drug therapy,while the experimental group was given the local target ultrasonic percutaneous delivery in accordance with the doctor′s advice on the basis of routine treatment. By comparing the two groups in terms of postoperative pain, swelling relief, starting time for getting out of bed, hospitalization time, and parental satisfaction of children, we investigated the effect of ultrasonic ultrasound transdermal delivery on children with swelling and analgesia after supracondylar fracture of the humerus.@*Results@#Postoperative pain relief and swelling relief were significantly reduced in the experimental group compared with the control group, and the difference between the two groups was statistically significant (P<0.05).The time of starting to get out of bed activity and hospitalization were respectively (8.20 ± 0.25) hours and (5.12 ± 0.27) days, and the control group was (23.80 ± 0.15) hours, (7.35 ± 0.38) days, respectively.The comparison was statistically significant (t=24.241, 7.654, all P<0.05). The parents' satisfaction in the experimental group was very satisfied, relatively satisfied, basically satisfied and unsatisfied, respectively 88.68% (47/53), 7.55% (4/53), 3.77% (2/53), 0, the control group was 64.00% (32/50), 26.00% (13/50), 10.00% (5/50), 0(0/50), the difference between the two groups was statistically significant (χ2=5.294 2, P<0.05).@*Conclusions@#The accuracy of ultrasonic percutaneous local target placement for the treatment of supracondylar fractures of the humerus in children is effective in the intervention of pain and swelling, and the comfort is better. It is a new choice for the treatment of limb fractures with pain in children.