Developing a Guideline for Endotracheal Suctioning of Adults With Artificial Airways in the Perianesthesia Setting in China.

PURPOSE: This study aimed to adapt a guideline for endotracheal suctioning of adults with artificial airways in the perianesthesia setting in China. DESIGN: This study was guided by the ADAPTE framework. METHODS: The development process consisted of setup, adaptation, and finalization phases. A heterogeneous consultant panel that included a patient representative was established to contribute guidance and suggestions regarding guideline development. Relevant evidence documents were searched, critically appraised, selected, and synthesized to develop the draft guideline. After revisions, the adapted guideline was evaluated by 20 external reviewers. FINDINGS: A 155-page adapted guideline was developed with 26 key recommendations (including 3 procedure phases and 17 points of care). CONCLUSIONS: The adapted guideline provided the best evidence for endotracheal suctioning of adults with artificial airways and supported practitioner decisions about appropriate endotracheal suctioning practices for this population. The study also lays the groundwork for future projects on quality improvement and knowledge translation.

Translation and validation of the Chinese powerlessness assessment tool.

The objectives of this study were to translate the powerlessness assessment tool (PAT) into Chinese, and to evaluate its psychometric performance. The PAT was translated into Chinese and was evaluated in patients with chronic wounds. Mean PAT scores were compared between various wound types to evaluate the scale's power to differentiate wound severity (PUSH score). There were 154 consecutive patients included in this study. All items were included, and the results of item-domain correlation (r ranged from 0.838 to 0.967) and small-group analysis (critical ratio, p < 0.05) were satisfactory. Furthermore, the Chinese PAT also showed good criterion validity when correlated with the Cardiff wound impact schedule (r = 0.726, p < 0.01). Exploratory factor analysis of these items extracted only two domains instead of the hypothesized three domains: self-perception of behavioral control and decision making (9 items) and emotional responses to perceived control (3 items), explained 82.045% of the variance. Sensitivity was demonstrated between patients with different activity of daily living, wound severity (PUSH score) and wound types. The internal consistency of all scales of the Chinese PAT was consistently high (Cronbach's alpha ranged from 0.939 to 0. 965) and split-half reliability was 0.901. In conclusion, the validated Chinese PAT has good psychometric properties, and may be used to objectively evaluate the powerlessness experience of Chinese patients with chronic wounds.

hsa_circ_0088196 Predicts Adverse Pregnancy Outcomes in Preeclampsia Patients and Contributes to Endothelial Cell Injury Via Modulating the miR-145-5p/FLT1 Axis.

Preeclampsia (PE) is a specific hypertension-related disease in pregnancies, causing adverse pregnancy outcomes. Endothelial cell dysfunction is a major etiology of PE, of which the regulation could affect disease progression. This study focused on hsa_circ_0088196, evaluating its clinical significance in PE and its effect on endothelial cell injury, aiming to identify a novel biomarker for PE and complete its regulating mechanism in disease development. The study enrolled 165 normal pregnancies and 165 pregnancies with gestational hypertension. The significance of hsa_circ_0088196 in discriminating gestational hypertension, predicting PE, and predicting adverse pregnancy outcomes was evaluated based on its serum expression. The effect and mechanism of hsa_circ_0088196 in HUVEC injury were assessed by CCK8, Transwell, ELISA, and western blotting. Significant downregulation of hsa_circ_0088196 could distinguish gestational hypertension pregnancies and predict the risk of PE. Gestational hypertension pregnancies developed PE showed a lower serum hsa_circ_0088196 level, which also discriminated PE patients, predicted severe conditions and adverse pregnancy outcomes. Overexpressing hsa_circ_0088196 alleviated the enhanced proliferation, migration, inflammation, and angiogenesis by hypoxia/reoxygenation (H/R), which was reversed by miR-145-5p. Silencing miR-145-5p showed similar effects on H/R-induced endothelial cell injury, which was reversed by FLT1. Moreover, FLT1 was positively regulated by hsa_circ_0088196, indicating its involvement in the regulation of HUVEC injury by hsa_circ_0088196. Reduced serum hsa_circ_0088196 served as a biomarker for the diagnosis of gestational hypertension, risk evaluation of PE, and the prediction of adverse pregnancy outcomes. hsa_circ_0088196 suppressed endothelial cell injury induced by H/R through modulating the miR-145-5p/FLT1 axis.

[Analysis of reasons and countermeasures for cancellation of oral and maxillofacial day surgery].

PURPOSE: To analyze the reasons for cancellation of oral and maxillofacial day surgery on the same day, and to propose countermeasures, so as to provide reference for improving the work efficiency and medical quality of day surgery ward. METHODS: The number of oral and maxillofacial day surgery cancellation cases in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from June 1, 2021, to December 31, 2021 was calculated and then the relevant causes were analyzed. RESULTS: During the statistical period, a total of 3134 patients underwent oral and maxillofacial day surgery. Among them, 72 (2.30%) cases were canceled of day surgery on the same day. Cancellation of oral and maxillofacial day surgery was as followed: patient-related factors(31, 43.05%), disease-related factors (28, 38.89%), epidemic of Covid 19-related(10, 13.89%), and hospital-related factors(3, 4.17%). The top three departments of oral and maxillofacial day surgery cancellation were Department of Preventive Dentistry(7, 7.37%), Department of Oral Surgery(22, 6.56%) and Department of Oral and Craniomaxillofacial Surgery(18,2.77%). CONCLUSIONS: The cancellation rate of oral and maxillofacial day surgery can be reduced by strengthening screening in anesthesia assessment at outpatient clinic, strengthening doctor-patient communication, strengthening health education and epidemic prevention and control in day outpatient management center.

[Establishment of a core curriculum of inadvertent perioperative hypothermia nursing based on clinical practice guidelines].

PURPOSE: To construct a core training curriculum of inadvertent perioperative hypothermia nursing. METHODS: The content of inadvertent perioperative hypothermia curriculum was developed by brainstorming method and expert consultation method based on literature review and clinical practice guideline. Statistical analysis was implemented using mean and coefficient of variation with SPSS 17.0 software package. RESULTS: We successfully established the content of inadvertent perioperative hypothermia curriculum, including 5 primary dimensions and 12 secondary items. In addition, content validity was built by expert evaluation method. CONCLUSIONS: The core curriculum of inadvertent perioperative hypothermia nursing based on scientific method provided reference for the nursing intervention study in future and may promote the development of perioperative nurse specialist.

[Comparison of two kinds of pain assessment tools for ICU patients in oral and maxillofacial surgery].

PURPOSE: To explore the validity of two kinds of pain assessment tools for ICU patients after oral and maxillofacial surgery. METHODS: A total of 30 ICU patients post oral and maxillofacial surgery were included, and the patients' pain was assessed by 2 independent research nurses with 2 kinds of pain assessment tools (CPOT and BPS) at the same time under non-pain stimulations and pain stimulation (non-invasive blood pressure measurement and closed endotracheal intubation suction). The repeated assessment point included rest state, during intervention, 20 minutes after intervention. For conscious patients, pain score was also obtained by 1 researcher with numerical rating scale (NRS) after closed endotracheal intubation suction. The data were analyzed by reliability and validation test using SPSS 17.0 software package. RESULTS: The internal consistency of CPOT and BPS was 0.809 and 0.878, respectively. In the analysis of discriminant validity, the pain stimulations scores of 2 scales were significantly higher than those in other assessment point (P<0.05); In the criterion validity, Spearman correlation coefficient between CPOT score and NRS score was 0.542, 0.461 between BPS score and NRS score during pain stimulation process. The results of sensitivity and specificity analysis revealed that when the CPOT score was cut by 3.5 point, the sensitivity and specificity were 55% and 96.7%, respectively, the area under ROC curve (AUC) was 0.799; when the BPS score was cut by 7 point, the sensitivity and specificity respectively were 50% and 100%, respectively, the area under ROC curve (AUC) was 0.743. CONCLUSIONS: Both CPOT and BPS have good reliability and validity, which may be used to assess the pain of ICU patients in oral and maxillofacial surgery.

[Application of key contact point management in health education at ICU for oral and maxillofacial cancer patients].

PURPOSE: To explore the effect of key contact point management in health education at ICU for oral and maxillofacial cancer patients. METHODS: Key contact point checklist was constructed by literature review, brain storm, patients review and expert consultation. The patients in the control group accepted routine health education, while patients in the experimental group accepted health education based on key contact point theory. The data were analyzed by nonparametric rank sum test using SPSS 17.0 software package. RESULTS: The key contact point checklist for oral and maxillofacial cancer patients consisted of 11 items. After intervention, the understanding rate and the satisfaction rate of patients in the experimental group were improved significantly than those in the control group. CONCLUSIONS: Health education model based on key contact point theory can effectively improve the quality of health education and patients' satisfaction.