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    10 May 2025, Volume 60 Issue 9
    Special Planning-Pediatric Rehabilitation Nursing Care
    Construction and preliminary verification of a postoperative pulmonary rehabilitation nursing program for children with double lung transplantation
    ZENG Fei, LAN Meijuan, GU Peipei, LIANG Jiangshuyuan, WANG Yandie, CAI Lingyun
    2025, 60(9):  1029-1035.  DOI: 10.3761/j.issn.0254-1769.2025.09.001
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    Objective To construct and preliminary verify a postoperative pulmonary rehabilitation nursing programme for children with double lung transplantation,aiming to promote early recovery and provide references for clinical nursing practice. Methods A convenience sampling approach was employed to select 25 cases pediatric patients who underwent bilateral lung transplantation at a tertiary teaching hospital in Hangzhou between January 2020 and September 2024,and they were divided into an experimental group and a control group according to the time of admission to the hospital. The experimental group received the newly developed post-transplant rehabilitation nursing program,which encompassed fluid management,mechanical ventilation,sequential oxygen therapy,pulmonary function training,exercise management,and process facilitation. In contrast,the control group received the standard post-lung transplantation rehabilitation protocol. Key outcomes,including mechanical ventilation duration,ICU stay,total hospitalization time,activity level,pulmonary function,incidence of adverse events and rehabilitation adherence,were compared between the 2 groups. Results Finally,24 cases completed the study,including 11 cases in the experimental group and 13 cases in the control group. After the intervention,the experimental group exhibited significantly shorter mechanical ventilation time compared to it in the control group (P=0.009). Additionally,at discharge,the intervention group demonstrated higher activity levels and better rehabilitation compliance(P<0.05). Conclusion The pulmonary rehabilitation nursing program for children with double lung transplantation is scientifically sound,safe,and feasible. The implementation of this program is beneficial for the early discontinuation of mechanical ventilation,improving postoperative mobility,and enhancing compliance with pulmonary rehabilitation.

    Construction and application of a graded nursing program for exercise rehabilitation in children with hematopoietic stem cell transplantation
    YAN Yinzhi, WEN Fang, WANG Min, ZHOU Xuemei, MA Jinling, WU Huifang, YAO Wenying
    2025, 60(9):  1036-1042.  DOI: 10.3761/j.issn.0254-1769.2025.09.002
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    Objective To construct a graded nursing program for exercise rehabilitation of children with hematopoietic stem cell transplantation(HSCT) and carry out a preliminary application,aiming to provide a basis for healthcare personnel to guide the exercise rehabilitation of children with HSCT. Methods Literature analysis and Delphi expert correspondence were used to construct a graded nursing program of exercise rehabilitation for children with HSCT. Through the convenience sampling method,children with HSCT in the hematology department of a tertiary-level children’s hospital in Suzhou City were selected as the study subjects from June-December 2023,of which 26 children with HSCT from September-December 2023 served as an experimental group,and 23 children with HSCT from June-August 2023 as a control group. The experimental group was applied with the graded nursing program of exercise rehabilitation,and the control group was applied with the conventional nursing care. The comparison of cardiorespiratory fitness and adverse events between the 2 groups after 8 weeks of exercise intervention was conducted,and the adherence to the exercise intervention programme in the experimental group was recorded. Results The final constructed graded care program of exercise rehabilitation for children with HSCT included 6 primary indicators,20 secondary indicators,and 44 tertiary indicators. Finally,21 children in the experimental group and 23 children in the control group were included in the study. After the intervention,the 6 min walking distance of the experimental group increased compared with that of the control group,and the difference was statistically significant(P<0.001). 85.71% of children in the experimental group had good exercise compliance,and there was no adverse events in both groups. Conclusion The constructed graded nursing program of exercise rehabilitation for children with HSCT is scientific,reasonable,safe and feasible,which can improve the cardiorespiratory capacity of children with HSCT and provide the basis for their exercise rehabilitation.

    Construction and effect evaluation of the respiratory rehabilitation calisthenics for school-age children with bronchial asthma
    LIU Xixuan, LIU Yulin, LIU Sha, YANG Fan, XIE Xiaohong, WANG Zijuan, LIU Lifang, WEI Hongyu
    2025, 60(9):  1043-1049.  DOI: 10.3761/j.issn.0254-1769.2025.09.003
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    Objective To construct the respiratory rehabilitation calisthenics for school-age children with asthma,and evaluate its effects,in order to provide a guidance for the scientific and effective implementation of respiratory rehabilitation in clinical work. Methods By convenience sampling method,the school-age children with asthma treated in the respiratory outpatient department of a tertiary specialized children’s hospital in Chongqing from December 2023 to February 2024 were selected. The children were randomly divided into an experimental group and the control group(25 of each group) by a random number table. Both groups were given routine asthma drug inhalation treatment and health education. Additionally,the experimental group received respiratory rehabilitation calisthenics training and the control group received conventional aerobic exercise training. After 3-month intervention,the effects of adherence to respiratory rehabilitation training,lung functions,exercise capacity,inspiratory muscle strength and occurrence of adverse events were evaluated between 2 groups. Results 24 children of each group completed the study. After 3-month intervention,the adherence to respiratory rehabilitation training,exercise capacity and inspiratory muscle strength were improved in the experimental group compared with those in the control group,and all differences were statistically significant(P<0.05). There were no adverse events in both groups. Conclusion The respiratory rehabilitation calisthenics for school-age children with asthma constructed in this study was scientific,feasible and safe,and could improve exercise capacity and inspiratory muscle strength for children with asthma.

    Research progress of early exercise rehabilitation in infants with congenital heart disease
    HUANG Panpan, LI Liling, HU Xiaojing
    2025, 60(9):  1050-1055.  DOI: 10.3761/j.issn.0254-1769.2025.09.004
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    Due to genetic abnormalities,hypoxic injury or surgical trauma,some children with congenital heart disease have neurodevelopmental disorders,mainly manifested as generalized hypotonia and exercise developmental delay. Infants have strong neuroplasticity. Early exercise rehabilitation is helpful to improve their exercise function and neurodevelopment and promote their rehabilitation. This paper reviews the assessment,implementation methods and effect evaluation of early exercise rehabilitation in infants with congenital heart disease,and puts forward hindering factors and nursing countermeasures,in order to provide references for clinical nursing practice.

    Specialist Nursing Practice and Research
    Study on the effect of pulmonary lobes surface projection localization combined with pulmonary segment drainage and sputum expectoration technique on airway clearance in patients with aspiration pneumonia
    CHEN Liou, ZHANG Wenting, LIU Junqi, WANG Yuncong, WANG Zhenlin, QI Sai, YANG Na
    2025, 60(9):  1056-1061.  DOI: 10.3761/j.issn.0254-1769.2025.09.005
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    Objective To investigate the effect of lung lobe surface projection localization combined with lung segment drainage sputum technique on airway clearance in patients with aspiration pneumonia,providing a reference for clinical nursing practice. Methods A convenience sampling method was used to select 62 patients with perioperative aspiration pneumonia secondary to brain diseases admitted to a tertiary A hospital in Beijing from May 2022 to October 2024 as the research subjects. A total of 31 patients admitted from August 2023 to October 2024 were assigned to a control group,and 31 patients admitted from May 2022 to July 2023 were assigned to an experimental group. The experimental group received lung lobe surface projection positioning combined with lung segment drainage sputum technique on top of conventional back percussion sputum clearance technique,while the control group received conventional back percussion sputum clearance technique. After the intervention,the differences in oxygenation state,inflammatory test indicators,treatment efficiency,vital signs and frequency of suction coughing between 2 groups were compared. Results After the intervention,the experimental group showed better oxygenation index,frequency of suction coughing,white blood cell count,percentage of neutrophils,procalcitonin levels,interleukin-6 levels,and treatment efficiency compared to those in the control group(P<0.05). There was no statistically significant difference in heart rate,respiratory rate,and C-reactive protein levels between 2 groups(P>0.05). Conclusion Lung lobe surface projection positioning combined can effectively promote the patients with aspiration pneumonia of loosening of sputum in the lungs,improve airway clearance efficiency,enhance the patient’s pulmonary ventilation and gas exchange capacity,improve oxygenation levels,and reduce systemic inflammatory levels.

    Evaluation of the effect of graded exercise rehabilitation on patients with acute exacerbation of chronic obstructive pulmonary disease
    YANG Nana, CHENG Chuanli, ZENG Hui, FU Dandan, WANG Yan, CHEN Yue, RAN Hongmin, FAN Hongjing, LONG Xia
    2025, 60(9):  1062-1067.  DOI: 10.3761/j.issn.0254-1769.2025.09.006
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    Objective To analyze the effect of graded exercise rehabilitation in patients with acute exacerbation of chronic obstructive pulmonary disease,and to provide references for clinical nursing practice. Methods A total of 70 patients with acute exacerbation of chronic obstructive pulmonary disease who met the criteria in the Department of Respiratory Medicine of a tertiary hospital in Zunyi City from September to December 2023 were randomly divided into an experimental group and a control group(with 35 cases in each group). The experimental group implemented graded exercise rehabilitation based on the Global Chronic Obstructive Pulmonary Initiative guidelines,and the control group implemented routine exercise rehabilitation. After intervention,the lung function,blood gas analysis,oxygenation index,6 min walking test and the incidence of complications related to non-invasive mechanical ventilation were compared between the 2 groups. Results Finally,34 cases were included in the experimental group and 35 cases in the control group. After intervention,the forced expiratory volume in the first second of the experimental group was improved compared with the control group (P<0.05). The 6-minute walking test of the experimental group was higher than that of the control group(P<0.05). The total incidence of non-invasive mechanical ventilation-related complications in the experimental group was lower than that in the control group(P<0.05). There was no significant difference in blood gas analysis and oxygenation index between the 2 groups(P<0.05). Conclusion The implementation of graded exercise rehabilitation based on the Global Chronic Obstructive Pulmonary Initiative guidelines can help patients with acute exacerbation of chronic obstructive pulmonary disease improve their respiratory function,improve their exercise endurance,and reduce non-invasive mechanical ventilation-related complications.

    A study of modified ankle pump exercise in stroke patients
    CAO Yun, SUN Guozhen, CHEN Feng, JI Xueli, YAN Mengwan, JING Lei, QIAN Kun
    2025, 60(9):  1068-1074.  DOI: 10.3761/j.issn.0254-1769.2025.09.007
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    Objective To investigate the effect of ankle pump exercises,based on hemodynamic mechanisms,on the prevention of venous thrombosis in stroke patients. Methods A total of 110 stroke patients,admitted to a tertiary A hospital in Jiangsu Province between June 2023 and June 2024,were selected using a convenience sampling method. The patients were divided into an experimental group and a control group,with 55 patients in each group. The experimental group received ankle pump exercise nursing interventions based on hemodynamic mechanisms,while the control group received routine nursing interventions. The incidence of lower extremity deep vein thrombosis,Pittsburgh Rehabilitation Participation Scale scores,subjective perceived fatigue,and exercise self-efficacy scores were compared between 2 groups on the 7th day of hospitalization. Results No dropouts occurred in either group. The incidence of deep vein thrombosis was significantly lower in the experimental group than it in the control group(P=0.004). The Pittsburgh Rehabilitation Participation scores on day 1,3,5,and 7 were higher in the experimental group compared to them in the control group(P<0.001). A significant time-dependent trend was observed in Pittsburgh Rehabilitation Participation scores(P=0.034). Subjective fatigue was significantly lower in the experimental group at various time points(P<0.001). Both groups showed an increase in exercise self-efficacy over time(P=0.016),with the experimental group demonstrating higher exercise self-efficacy than the control group on the day before discharge(P=0.003). Conclusion Ankle pump exercises,based on hemodynamic mechanisms,can effectively reduce the incidence of deep vein thrombosis in stroke patients,enhance rehabilitation participation and exercise self-efficacy,without increasing subjective fatigue.

    Analysis of symptoms network in patients with acute type A aortic dissection and its implications in emergency triage
    HE Mei, XIONG Jie, HUANG Sufang, LI Fangfang, LI Jin, REN Lanlan, CHEN Min
    2025, 60(9):  1075-1079.  DOI: 10.3761/j.issn.0254-1769.2025.09.008
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    Objective To construct a symptom network in patients with acute type A aortic dissection (ATAAD),so as to provide theoretical basis for the screening of dissection ATAAD during emergency pre-screening triage. Methods There were 433 patients diagnosed with ATAAD during 2019 to 2023 in an emergency department of a tertiary hospital in Wuhan. Their basic information and medical records were reviewed by self-designed data questionnaire. UCINET6.0 software was used to construct a symptom network,analyze the centrality index and determine the core symptoms. Symptom distribution of patients with positive and negative blood pressure in extremities was analyzed in the further. Results The most common symptoms in patients with type A aortic dissection were chest pain(77.37%),back pain(42.96%),and sweating(29.79%). In the symptom network,chest pain had the highest degree(rs=659). The closeness of chest pain,chest tightness,shortness of breath,back pain,nausea and vomiting,limb numbness and fatigue were same(rc=93.33). Fatigue has the highest betweenness(rb=13.69). Patients with positive limbs blood pressure mainly reported chest pain(70.17%),back pain(44.96%),and nausea and vomiting(19.33%),while those with negative limb blood pressure mainly reported chest pain(63.64%),back pain(63.64%),and orosphyalgia(39.40%). Orosphyalgia had the highest degree(rs=20). Conclusion The symptoms of ATAAD are complex and varied in patients. During triage,nurses should measure the limb blood pressure when patients complained chest pain alone or when combined with other hypoperfusion symptoms,such as back pain,chest tightness,sweating,near-death sensation,and shortness of breath. Aortic dissection cannot be ruled out in patients with negative blood pressure when they had chest pain,back pain or orosphyalgia.

    Potential profile analysis and influencing factors of kinesiophobia in patients with peritoneal dialysis
    XIE Min, QI Wenkai, YIN Ling, ZHANG Xuan, ZHAO Ruqin
    2025, 60(9):  1080-1086.  DOI: 10.3761/j.issn.0254-1769.2025.09.009
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    Objective To explore the latent profiles of kinesiophobia among patients with peritoneal dialysis and analyze the influencing factors of different categories. Methods A convenience sampling method was used to select peritoneal dialysis patients treated in the outpatient and ward of nephrology department in 7 tertiary A hospitals in Jiangsu Province from December 2023 to March 2024. General data questionnaire,Tampa Kinesiophobia-11 Scale,Exercise Self-efficacy Scale,Exercise Social Support Scale and Self-Rating Anxiety Scale were used for investigation. Results A total of 291 cases were included,and 3 potential categories of kinesiophobia were finally identified,namely low kinesiophobia-active exercise group(20.96%),high kinesiophobia-exercise avoidance group(24.06%),and moderate kinesiophobia-general exercise group(54.98%). Exercise self-efficacy,exercise social support,anxiety,monthly per capita household income,marital status and daily number of dialysis dose were influencing factors of kinesiophobia in peritoneal dialysis patients(P<0.05). Conclusion There are significant category characteristics of kinesiophobia in patients with peritoneal dialysis. Medical staff should judge the category and influencing factors of kinesiophobia in time,and take targeted interventions to reduce the level of kinesiophobia in patients.

    Oral health management dilemmas of chronic periodontitis patients with implant dentures:a qualitative study
    CHEN Bingqian, ZHAO Bin, SUN Jiarong, HAO Sifang, HOU Xiaoli
    2025, 60(9):  1087-1092.  DOI: 10.3761/j.issn.0254-1769.2025.09.010
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    Objective To explore the oral health management dilemmas of chronic periodontitis patients with implant dentures,so as to provide a reference for formulating scientific and effective oral nursing intervention programs. Methods Based on the information-motivation-behavioral skills model(IMB),the interview outline was formulated. Using the purposive sampling method,patients with chronic periodontitis who underwent implant restoration in a tertiary A stomatological hospital in Taiyuan City,Shanxi Province from April to June 2024 were selected for semi-structured interviews. The data were analyzed by means of directed content analysis. Results A total of 3 core themes were extracted,covering 10 sub-themes,namely knowledge deficiency and information dilemma(lack of oral health-related knowledge,cognitive misunderstanding and memory deviation,difficulty in identifying miscellaneous information),coexistence of emphasis and avoidance(perceived benefits of oral health management,positive feedback reinforcing internal motivation,avoidance induced by psychological burden,the duality of diverse social networks),behavioral skills transformation difficulties(difficulties in home maintenance practice,insufficient professional guidance and support,and uneven self-efficacy). ConclusionThe oral health management behavior of chronic periodontitis patients with implant dentures is affected by many factors. We should aim to develop innovative oral health services based on Internet,bridge the cognitive misunderstanding and memory bias of patients,stimulate the internal driving machine of oral health behavior,strengthen the external support of multiple social networks,refine the teaching model of oral health management,and empower oral health self-management.

    Experiences of disease self-control among patients with chronic obstructive pulmonary disease:a qualitative study
    QIN Chunlan, WU Zhenyun, QIAN Hongying, ZHAO Qian, SUN Jinting
    2025, 60(9):  1093-1098.  DOI: 10.3761/j.issn.0254-1769.2025.09.011
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    Objective To understand the real-life experiences of patients with chronic obstructive pulmonary disease(COPD) in disease self-control and to inform clinical nursing practice. Methods From March to May 2024,a phenomenological research method was used to conduct semi-structured interviews with 15 patients with COPD who were either outpatients or inpatients in a tertiary hospital in Suzhou City,China,and the data were analyzed using the Colaizzi 7-step analysis method. Results Totally 3 themes and 9 sub-themes were extracted,namely self-control challenges due to cognitive deficits(lack of knowledge leads to ambiguous control direction;cognitive bias hinders control strategy formulation;negative perception leads to control avoidance),weakening trend of self-control behaviors(decision-making conflicts between immediate indulgence and delayed gratification;lack of reinforcement mechanisms leads to psycho-emotional depletion;external temptations lead the self to imitate bad behavior),urgent need for multiple supports to help with self-control(the desire for continuity and stability of family support,the need for professionalism and accuracy of healthcare guidance,and the expectation for rationality and matching of resource allocation). Conclusion Healthcare professionals should pay attention to the real experience of COPD patients in the process of disease self-control,help them effectively deal with the challenges of disease self-control,strengthen self-control behaviors,and satisfy their diversified needs by strengthening the support of families,professionals,and the community to improve poor outcomes and reduce the cost of healthcare services.

    Development and application of a Fear of Movement Assessment Scale for patients with peripherally inserted central catheters
    LI Ziwei, FENG Lijuan, CHEN Xusheng, HUANG Yi, YANG Jie
    2025, 60(9):  1099-1106.  DOI: 10.3761/j.issn.0254-1769.2025.09.012
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    Objective To develop and test the reliability and validity of a Fear of Movement Assessment Scale for patients with peripherally inserted central catheters(PICC),and to make a preliminary application. The aim is to provide an effective tool for nurses to accurately assess the level of fear of movement in patients with PICC and to develop targeted interventions. Methods Based on the psychological imagination belief model,the initial version of the scale was formed through literature review,semi-structured interviews,expert correspondence and a pre-survey. From February to April 2024,211 patients with PICCs were recruited from a tertiary hospital in Wuhan by convenience sampling for project analysis and reliability and validity test. From May to July 2024,256 patients with PICCs from 3 tertiary hospitals in Wuhan were selected by convenience sampling method for further validating the structural validity of the scale and for preliminary application. Results A total of 203 valid questionnaires were collected in February to April 2024,228 valid questionnaires were collected in May to July 2024. The fear of movement assessment scale for patients included 4 dimensions,including the perception of risk,belief of fear,avoidance of movement,and dysfunction,with a total of 17 items. The Cronbach’s α coefficient was 0.922;the split-half reliability was 0.867;the test-retest reliability was 0.958. The content validity index at the item level was 0.867~1.000,and the content validity index at the scale level was 0.951. Both exploratory factor analysis and parallel analysis extracted 4 factors. The cumulative variance contribution rate was 61.348%. Confirmatory factor analysis showed that the model fitted well. The preliminary application results showed that the score of fear of movement in patients with PICCs was 53.95±11.08,which was moderately high. Conclusion The Fear of Movement Assessment Scale for patients with PICCs has good measurement properties,and can be used to assess the degree of fear of movement in patients with PICCs.

    Reliability and validity test of the Chinese version of the Urinary Incontinence Awareness and Attitude Scale
    CHENG Zhiqiang, ZHANG Baozhen, TANG Liping, LI Jing, XIA Jiaoyun, WEI Xueyan, GONG Zhixian, ZHANG Meizhen, LI Lusi
    2025, 60(9):  1107-1112.  DOI: 10.3761/j.issn.0254-1769.2025.09.013
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    Objective To translate the Urinary Incontinence Awareness and Attitude Scale(URINAS) and test its reliability and validity. Methods The Chinese version of the URINAS was developed by Brislin’s translation model for translation,back translation,cultural adaptation,and pilot investigation. A convenience sampling method was used to select 384 urinary incontinence patients who visited a tertiary hospital in Nanchang,Jiangxi Province from June 2024 to October 2024 for investigation,in order to evaluate the reliability and validity of the scale. Results The Chinese version of the URINAS consisted of 5 dimensions with 26 entries. The Cronbach’s alpha coefficient of this scale was 0.843;the folded half reliability was 0.917;the retest reliability was 0.852. The content validity of the scale at the level of the entries ranged from 0.846 to 1.000,and that at the level of the scale was 0.979. A total of 5 metrics were extracted by exploratory factor analysis,and the cumulative variance contribution rate of 74.286%. The results of the validation factor analysis showed a chi-square/degree of freedom of 2.268,a root mean square error of approximation of 0.064,a standardized fit index of 0.916,a Tucker-Lewis index of 0.923,a comparative fit index of 0.906,and a goodness-of-fit index of 0.922. Conclusion The URINAS has good reliability and validity,and can better reflect the level of patients’ cognition and attitude towards urinary incontinence,thus providing theoretical basis for the development of corresponding intervention programs for such patients.

    Enteral and Parenteral Nutrition
    Analysis influencing factors of nutritional status changes in pediatric liver transplant patients and nursing revelation
    YANG Jing, WANG Huafen, LU Fangyan, BAO Ruijie, ZHU Li
    2025, 60(9):  1113-1119.  DOI: 10.3761/j.issn.0254-1769.2025.09.014
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    Objective To understand the changing trend of nutritional status of children undergoing liver transplantation within 6 months after discharge,and to explore its influencing factors,in order to provide guidance for the clinical formulation of personalized nutritional intervention programs. Methods By the convenient sampling method,153 children undergoing liver transplantation admitted to the liver transplantation center of a tertiary A hospital in Hangzhou from January 2023 to January 2024 were selected as the research subjects. Their basic and clinical data were collected. The nutritional status at the 1 day before surgery and 1 month,3 months,and 6 months after discharge was evaluated by the standard deviation evaluation method of children’s nutritional status. According to the changing trend of their nutritional status,they were grouped. Univariate and multivariate Logistic regression were used to analyze the influencing factors of the changing trend of nutritional status in children undergoing liver transplantation. Results A total of 144 children who underwent liver transplantation were ultimately included in the study. The incidence of malnutrition at 1 month,3 months,and 6 months after discharge was 66.0%,54.9%,and 53.5%,respectively. According to the changing trend of nutritional status of children undergoing liver transplantation,they were divided into 3 groups:54 cases(37.5%) in the good nutritional status group,24 cases(16.7%) in the fluctuating nutritional status group,and 66 cases(45.8%) in the poor nutritional status group. The results of multivariate Logistic regression analysis showed that birth weight,feeding method within 6 months after birth,age of caregivers and learning situation of nutritional knowledge were the influencing factors of the changing trend of nutritional status in children undergoing liver transplantation(P<0.05). Conclusion The incidence of malnutrition in children undergoing liver transplantation is high within 6 months after discharge; medical staff should closely collaborate with families to formulate and implement staged personalized nutritional intervention measures based on the specific conditions and influencing factors of the children to effectively improve the nutritional status of the children after transplantation.

    RareI Disease and Critical Care
    Nursing care for postoperative laryngeal function rehabilitation in a patient undergoing primary voice prosthesis implantation after total laryngectomy
    SHI Meiqin, WU Jianfang, ZHANG Duo, WU Chunping, CHEN Ling, TAO Lei
    2025, 60(9):  1120-1123.  DOI: 10.3761/j.issn.0254-1769.2025.09.015
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    This article reports on the nursing experience in the rehabilitation of laryngeal function with primary tracheoesophageal puncture for voice prosthesis rehabilitation after laryngectomy. The core elements of postoperative nursing included:the use of a Heat and Moisture Exchanger(HME) for airway humidification to maintain pulmonary health;the implementation of progressive speech training to aid in the reconstruction of speech function;continuous monitoring and dilatation training to ensure the appropriate size of the stoma,thereby ensuring smooth breathing and speech;nasal airflow-inducing training for the promotion of olfactory rehabilitation;standardized maintenance of the voice prosthesis to extend its lifespan and reduce the occurrence of complications. After meticulous postoperative care,the patient showed good recovery of speech,olfaction,and respiratory function at the one-month follow-up,with the stoma diameter maintained at an ideal size and no complications occurred.

    Nursing care for a patient with cytokine release syndrome following T-cell immunotherapy
    GU Qian, HUANG Xi, SHI Weixiong, WU Jing, TAN Ruoming, WANG Feng
    2025, 60(9):  1124-1127.  DOI: 10.3761/j.issn.0254-1769.2025.09.016
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    To summarize the nursing experience of a patient with relapsed/refractory diffuse large B-cell lymphoma who suffered from cytokine release syndrome after chimeric antigen receptor T-cell therapy. The main nursing experiences include:implementing emergency care for distributive shock caused by cytokine storm;carrying out the nursing of lung ventilation protection strategies;strengthening detailed skin care;prevention,control and care of hospital-acquired infections in an immunosuppressed state. After active treatment,the patient was transferred to the general ward 9 days later and discharged 27 days later.

    Nursing care of a patient undergoing an abandoned liver transplantation combined with ALPPS
    WANG Yan, PAN Wenyan, CHENG Lihong, ZHOU Zilin, HU Yancheng, ZHANG Xiaoyun
    2025, 60(9):  1128-1131.  DOI: 10.3761/j.issn.0254-1769.2025.09.017
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    To summarize the nursing experience of a patient who underwent an abandoned liver transplantation combined with associating liver partition and portal vein ligation for staged hepatectomy. The main points of nursing included the establishment of a multidisciplinary team before surgery to ensure the smooth progress of the surgery,intraoperative preservation of the abandoned liver and healthcare collaboration for precise portal vein pressure monitoring,postoperative implementation of capacity management for ensuring perfusion of abandoned liver,dynamic monitoring of abandoned liver hyperplasia and prevention of small liver syndrome,individualized immune management and prevention of acute rejection reactions,nutritional support and exercise rehabilitation,strengthening protection and isolation strategies to comprehensively reduce the risk of infection. After treatment and nursing,the patient was discharged on the 28th of surgery.

    Evidence Synthesis Research
    Systematic review of risk prediction instruments for central line associated bloodstream infections in ICU patients
    ZHOU Miao, CHEN Xing, PENG Fei, SUN Shangxue, LI Yangyang
    2025, 60(9):  1132-1139.  DOI: 10.3761/j.issn.0254-1769.2025.09.018
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    Objective To systematically analyze the risk prediction instruments for central line associated bloodstream infection in ICU patients,with a view to provide references for clinical practice. Methods The PubMed,Embase,Web of Science,Cochrane Library,CINAHL,CNKI,WanFang,VIP and CBM Database were searched from inception to May 2024. There were 2 researchers who independently screened the literature,extracted the information,and assessed the risk of bias and applicability of the included literature. Results 11 studies were involved in the final review,involving 9 risk prediction models and 2 risk assessment tables,9 of which validated the predictive efficacy or reliability and validity of the instruments. Conclusion The risk prediction instruments for central line associated bloodstream infection in ICU patients had good predictive efficacy and applicability,but the overall risk of bias was high. It is recommended that further examination,verification the existing instruments should be conducted,or to build a prediction instrument with low risk of bias and high applicability.

    Rehabilitation effects based on immersive virtual reality as a treatment for peripheral vestibular dysfunction:a Meta-analysis
    LIU Xiaoyi, WANG Hong, ZHOU Zhicong, SUN Xu, WANG Yiru, TONG Ziwei, LIU Xiaoying
    2025, 60(9):  1140-1145.  DOI: 10.3761/j.issn.0254-1769.2025.09.019
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    Objective To systematically evaluate the rehabilitation effect of immersive virtual reality technology for patients with peripheral vestibular dysfunction,and to provide theoretical basis and practical guidance for the design of efficient rehabilitation training programs. Methods PubMed,Embase,Cochrane Library,Web of Science,CINAHL,CNKI,Wanfang Database,VIP Database,and China Biomedical Literature Database were searched for randomized controlled trials on the intervention effect of immersive virtual reality technology in patients with peripheral vestibular dysfunction from inception to February 2025. RevMan5.4 software was used to perform meta-analysis of the literature that met the quality standards. Results A total of 10 papers with 491 patients with peripheral vestibular dysfunction were included. Meta-analysis showed that immersive virtual reality technology improved vertigo symptoms in patients with peripheral vestibular dysfunction compared with conventional vestibular rehabilitation care[SMD=-1.41,95%CI(-1.58,-0.70),P<0.001],and subgroup analysis showed that the frequency of intervention was <5 times/week[SMD=-1.31,95%CI=(-1.96,-0.66),P<0.001],single intervention duration<30 min [SMD=-1.45,95%CI=(-2.21,-0.70),P<0.001],and intervention period≤7 weeks[SMD=-1.49,95%CI(-2.04,-0.94),P<0.001] were more significant. Immersive virtual reality technology reduced the risk of falls[MD=4.66,95%CI(3.84, 5.48),P<0.001],and improved anxiety and depression[SMD=2.65,95%CI(1.98,3.33),P<0.001]. Conclusion Immer-sive virtual reality technology improves vertigo symptoms,reduces the risk of falls,and improves anxiety and depres-sion symptoms in patients with peripheral vestibular dysfunction,in which the intervention period of ≤7 weeks,<5 training sessions per week,and each training session of <30 min are better for improving vertigo symptoms in patients with peripheral vestibular dysfunction.

    Systematic review of readiness assessment tools for advance care planning in older adults
    PENG Yingjie, LIU Aihong, ZHU Wenli, MEI Yuxin, ZHOU Meng, GUAN Wenjing
    2025, 60(9):  1146-1153.  DOI: 10.3761/j.issn.0254-1769.2025.09.020
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    Objective To systematically evaluate the advance care planning readiness assessment tools applicable to the elderly and to provide a reliable assessment tool for the development of advance care planning. Methods PubMed,Web of Science,Cochrane Library,Embase,CINAHL,Yimaitong,Wanfang Database,China National Know-ledge Network,VIP Database,and China Biomedical Literature Database were systematically searched. The search time limit is from database establishment to April 30,2024. Pre-established medical care plan readiness assessment tools that meet the inclusion criteria were screened,and the “consensus based standards for the selection of health measurement instruments” was used to evaluate the methodological quality and measurement attributes of the inclusion assessment tools. The improved version of the evidence quality evaluation and recommendation strength grading method is used to grade the evidence of the assessment tool and form the final recommendation opinion. Results A total of 14 articles were included,including 10 advance care planning readiness assessment tools suitable for the elderly. None of the articles reported cross-cultural validity,measurement error,and responsiveness. The content validity and internal consistency of the Chinese Advance Care Planning Readiness Scale and the Advance Care Planning Readiness Scale for Chronic Disease Patients were both “adequate”,with A-level recommendations,and the remaining assessment tools were all B-level recommendations. Conclusion There are various types of advance care planning readiness assessment tools for the elderly,but the methodological quality needs to be improved and the measurement properties need to be further evaluated. It is temporarily recommended to use the Chinese Advance Care Planning Readiness Scale and the Advance Care Planning Readiness Scale for Chronic Disease Patients.