Study on the Effectiveness and Value of Evidence-Based Nursing and Predictive Nursing in Emergency Treatment of Upper Gastrointestinal Bleeding.

Objective: To study the effectiveness and value of evidence-based nursing and predictive nursing in emergency treatment of upper gastrointestinal bleeding. Methods: A total of 100 patients with upper gastrointestinal bleeding in our hospital were selected. The period was from January 2020 to June 2022. They were grouped according to the double color ball method, 50 cases in the control group were given routine nursing, and 50 cases in the observation group were given evidence-based nursing combined with predictive nursing. The key points of evidence-based nursing are to identify the evidence-based question, search for relevant literature, identify scientifically effective nursing measures, and develop nursing care plans that are tailored to the patient's specific situation based on evidence and clinical experience. Predictive nursing requires nurses to have a high level of awareness and risk prevention consciousness to provide care for early signs of bleeding and prevent the occurrence of complications. The psychological state scores, clinical-related indicators, clinical efficacy, incidence of complications, nursing satisfaction, and quality of life scores of the two groups were compared. Results: After the intervention, the SAS score (42.25 ± 1.67) and SDS score (43.59 ± 1.86) of the observation group were lower than those of the control group, the bleeding times (2.41 ± 0.45) of the observation group were less than those of the control group, the hemostasis time (30.12 ± 5.38d) and hospitalization time (5.01 ± 1.11d) of the observation group were shorter than those of the control group, and the difference was statistically significant (all P < .05). The total effective rate of hemostasis (96.00%), patient satisfaction (98.00%), and scores of physical health (88.98 ± 5.59), psychological function (91.08 ± 5.11), material life state (90.54 ± 6.46) and social function (89.59 ± 5.78) in GQOLI-74 scores in the observation group were higher than those in the control group. The incidence of complications (6.00%) in the observation group was lower than that in the control group, and the difference was statistically significant (all P < .05). Conclusion: Upper gastrointestinal bleeding is a common emergency in gastroenterology, characterized by rapid onset, severe symptoms, and quick changes. Therefore, in order to expedite the recovery of patients with acute upper gastrointestinal bleeding and ensure their safety, it is necessary to provide effective clinical emergency nursing care. Evidence-based nursing can help nurses take appropriate nursing measures based on the best and latest evidence, to meet the reasonable individualized needs of patients. Predictive nursing is a nursing model that predicts potential nursing risks in advance and takes corresponding preventive measures. It can timely and systematically address risks in nursing and promote improvements in the effectiveness of disease treatment. The combined application of evidence-based nursing and predictive nursing can improve the hemostatic efficiency of patients with upper gastrointestinal bleeding, improve the psychological state and quality of life, reduce the incidence of complications, and obtain higher satisfaction. The combined application of these two nursing models has positive implications for improving nursing efficiency, enhancing patient cooperation during emergency care, improving hemostasis effectiveness, enhancing quality of life, and fostering a harmonious nurse-patient relationship.

[Epidemiological analysis of in patients with sepsis in a large tertiary general hospital in Southwest China].

OBJECTIVE: To analyze the epidemiological characteristics of hospitalized patients diagnosed with sepsis in a large class III general hospital in Southwest China in a period of 2 years, and to explore the risk factors related to death in patients with sepsis. METHODS: A retrospective study was conducted to select patients with sepsis admitted to Sichuan Provincial People's Hospital from September 1, 2021 to August 31, 2023, and general characteristics such as gender, age, discharge diagnosis, discharge department, hospitalization cost, length of stay, and prognosis during hospitalization were collected. The baseline of two groups of patients was compared, and the risk factors of in-hospital cause of death in patients with sepsis were analyzed by multivariate Logistic regression. RESULTS: A total of 3 568 patients with sepsis were included with median age of 58 (35, 74) years old. Of all patients, there were 2 147 males (60.17%). The median length of hospitalization was 13 (8, 24) days, and the median hospitalization cost was 3.98 (1.87, 8.83) ten thousand yuan. The departments with more than 100 cases of sepsis in 2 years were central intensive care unit (ICU), pediatrics department, nephrology department, emergency medicine department, emergency intensive care unit (EICU), infectious department, respiratory medicine department, hematology department, neonatal care unit and emergency surgical department. A total of 1 210 patients (33.91%) admitted to ICU (including central ICU and EICU). The hospitalization cost of ICU patients were higher [6.7 (3.1, 15.5) ten thousand yuan], the hospitalization duration was longer [9 (3, 17) days], and the mortality was higher [35.29% (427/1 210)]. Among 3 568 patients with sepsis, 448 died and 3 120 survived during hospitalization. The age, male proportion and hospitalization cost of patients with sepsis in the death group were significantly higher than those in the survival group [age (years old): 75 (60, 86) vs. 57 (30, 71), male proportion: 67.86% (304/448) vs. 59.07% (1 843/3 120), hospitalization cost (ten thousand yuan): 6.7 (3.0, 16.9) vs. 3.7 (1.8, 8.1)], the ratio of diabetes mellitus was significantly lower than that of survival group [4.91% (22/448) vs. 10.45% (326/3 120)], the length of hospitalization was shorter than that of survival group [days: 10.0 (3.0, 19.0) vs. 13.0 (8.0, 24.0)], the differences were statistically significant (all P < 0.01). Multivariate Logistic regression analysis showed that male [odds ratio (OR) = 0.75, 95% confidence interval (95%CI) was 0.59-0.96], elder (OR = 1.04, 95%CI was 1.03-1.05) and diabetes (OR = 0.32, 95%CI was 0.19-0.54) were independent risk factors for in-hospital death in patients with sepsis (all P < 0.05). CONCLUSIONS: Sepsis is a heavy burden in Southwest China, especially for ICU, with high mortality, high hospitalization costs, and heavy economic burden on patients and society. Male, elder and diabetes were independent risk factors for in-hospital death of sepsis patients.

hsa_circ_0005721 triggers proliferation, migration and invasion of osteosarcoma by upregulating the linear transcript TEP1.

PURPOSE: This study aimed to illustrate the biological role of hsa_circ_0005721 in the development of osteosarcoma and the molecular mechanism. METHODS: hsa_circ_0005721 levels in 30 pairs of osteosarcoma and non-tumor tissues were detected by quantitative real-time polymerase chain reaction (qRT-PCR). Functional experiments were conducted to assess the influence of hsa_circ_0005721 on proliferative, metastatic and apoptotic rates of osteosarcoma cells. The downstream target of hsa_circ_0005721 and their co-regulatory mechanism in malignant development of osteosarcoma were analyzed by dual-luciferase reporter assay and rescue experiments, respectively. RESULTS: hsa_circ_0005721 was upregulated in osteosarcoma tissues and cell lines. Knockdown of hsa_circ_0005721 suppressed proliferative and metastatic rates of U-2OS and Saos-2 cells, and stimulated apoptosis. Serving as a ceRNA, hsa_circ_0005721 upregulated the linear transcript TEP1 by competitively binding miR-16-5p, thus exerting its biological functions in regulating osteosarcoma development. CONCLUSIONS: This study for the first time identified the upregulated hsa_circ_0005721 in osteosarcoma, which triggers the malignant development of osteosarcoma by upregulating the linear transcript TEP1.

Diagnostic value of rapid on-site evaluation in interventional pulmonology: A protocol for systematic review and meta analysis.

BACKGROUND: Rapid on-site evaluation (ROSE) is a kind of rapid evaluation of specimen satisfaction, preliminary diagnosis and priority strategy, the diagnostic accuracy of ROSE in the field of pulmonary intervention shows wide variation. The aim of the study was to further clarify the accuracy and diagnostic efficacy of ROSE in interventional pulmonology. METHODS: This review summarizes and meta-analyzes studies of ROSE in interventional pulmonology, the ROSE diagnoses would be compared with the final pathologic diagnoses. The following electronic databases have been searched: PubMed, Cochrane Library, Embase, Web of science, CNKI, and WANFANG DATA. The methodologic quality of studies has been assessed using the Quality of Diagnostic Studies (QUADAS-2) instrument. This review is conducted using standard methods for systematic reviews of diagnostic accuracy studies. STATA SE 12.0 is used for data synthesis and analysis. RESULTS: This review evaluates the accuracy and diagnostic efficacy of ROSE in interventional pulmonology, and the process factors that may influence the ROSE diagnosis are analyzed, such as Smear method, profession of smear technician, staining method, Profession of stain technician, Profession of reading slides, invasive procedure, Anesthesia method and etc. CONCLUSION:: This review will stimulate proper evaluation of ROSE and provide assistance for clinical practice.

[Effect of schistosomiasis control strategy based on infection source control of Poyang Lake region in Yongxiu County promotion zone].

OBJECTIVE: To evaluate the effect of schistosomiasis control strategy with emphasis on infection source control in the Yongxiu County promotion zone of Poyang Lake region. METHODS: The Wucheng Township of Yongxiu County was selected as the observation site, and the effect of the comprehensive control strategy was evaluated by using the method of field surveys combined with retrospective investigations. RESULTS: In 2010, there were 17 persons whose stool tests for schistosome infection were positive, and the number of calculated schistosomiasis patients was 2,331. The infection rate of cattle was 4.5%, and the area with infected Oncomelania hupensis snails was 10.00 hm². In 2011, the comprehensive control strategy was carried out, and in 2012, there were no cattle in the promotion zone. In 2013 and 2014, there were no schistosomiasis patients with positive stool tests. In 2014, no schistosome infected snails were found. CONCLUSION: The control strategy with emphasis on infection source control effectively controls the transmission of schistosomiasis in Yongxiu County promotion zone.