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    10 September 2025, Volume 60 Issue 17
    Special Planning-Patient Safety Management
    Expert consensus on in-hospital transfer safety management for patients undergoing invasive mechanical ventilation
    Critical Care Professional Committee of Chinese Nursing Association(Written Committee:XIONG Jie, SUN Hong, WU Xiaoying, GUAN Xin, LI Liming, ZHANG Li, TIAN Yongming)
    2025, 60(17):  2053-2055.  DOI: 10.3761/j.issn.0254-1769.2025.17.001
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    Objective To establish an expert consensus on in-hospital transfer safety management for patients undergoing invasive mechanical ventilation,providing guidance for clinical medical teams to conduct standardized transfers,reduce transfer risks,and ensure patient safety. Methods Through systematic searching,screening,evaluation,and summary of evidence related to in-hospital transfer safety management for patients on invasive mechanical ventilation,we extracted recommendations to form a preliminary draft of the expert consensus. From July to October 2024,totally 2 rounds of expert consultations,and 2 rounds of expert reviews were conducted,and the content was refined and finalized based on expert feedback. Results The final consensus encompasses 9 aspects,including transfer assessment and decision-making,pre-transfer preparation of medical staff,pre-transfer patient preparation,pre-transfer equipment preparation,pre-transfer medication preparation,monitoring and intervention during transfer,emergency events and management,transfer handover and documentation,and post-transfer management. Conclusion This consensus demonstrates strong practicality and operability,offering professional guidance for enhancing the safety of in-hospital transfers for patients on invasive mechanical ventilation.

    Analysis of influencing factors and pathway of medication safety behaviors in elderly cancer patients
    ZHANG Maomao, ZHANG Liuliu, WU Aizhen, ZOU Meiying, JIAO Yuchen, WU Bing, LIU Chunli, YU Rong
    2025, 60(17):  2056-2062.  DOI: 10.3761/j.issn.0254-1769.2025.17.002
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    Objective To explore the current situation of medication safety behavior of elderly cancer patients and the path relationship of various influencing factors for improving medication safety behavior. Methods A total of 340 elderly cancer patients were investigated by a demographic questionnaire,the Medication Safety Behavior Scale,the Medication Literacy Scale,the Family Care Index Questionnaire,and the Chinese version of the Empowerment Scale for Cancer Patients from August to December 2024. The multiple linear regression analysis was applied to analyze influencing factors,and data were analyzed using SmartPLS 4.0 to construct a partial least squares structural equation model with path analysis. Results A total of 307 valid questionnaires were collected. The mean medication safety behavior score was 31.89 ± 5.38. Residential area,drug literacy,family care,and health empowerment are factors that affect medication safety in elderly cancer patients,accounting for 37.3% of the total variation. The path analysis results indicated that health empowerment(β=0.480),medication literacy(β=0.154),and family care(β=0.227) positively correlate with medication safety behavior. Health empowerment played a partial mediating role between family care and medication safety behavior,as well as between medication literacy and medication safety behavior. The mediating effects are 0.125 and 0.332(P<0.001),accounting for 35.51% and 68.31% of the total effect,respectively. Conclusion Medication safety behaviors among elderly cancer patients are at a median level and influenced by multiple factors. By improving their levels of health empowerment,healthcare professionals can motivate patients to take an active role in medication safety management. Further,promoting education on medication knowledge and teaching relevant medical skills,and together with guiding patients to perceive family care and support,can collectively improve their overall medication safety behaviors.

    Evaluation of the effect of bedside ultrasound combined with joint movement protractor on preventing secondary ectopic PICC in extremely low birth weight infants
    CUI Lulu, LI Pingping, SU Xin, JIN Ge
    2025, 60(17):  2063-2068.  DOI: 10.3761/j.issn.0254-1769.2025.17.003
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    Objective The application effect of bedside ultrasound combined with joint movement protractor on the accurate monitoring and management of joint range of motion in extremely low birth weight infants was evaluated to reduce the incidence of secondary ectopic PICC in extremely low birth weight infants. Methods Convenience sampling was used to select 128 extremely low birth weight infants admitted to the neonatal intensive care unit of a tertiary hospital in Zhengzhou,Henan Province from February to September 2024. Among them,infants enrolled between June and September 2024 were assigned to an experimental group,while those enrolled between February and May 2024 were assigned to a control group,with 64 cases in each group. Whereas the experimental group,based on the control group,combined bedside ultrasound with a joint goniometer for precise monitoring and management of limb movement range in children with upper limb catheterization;the control group received routine prevention and management of PICC secondary displacement. After intervention,the incidence of PICC secondary displacement,the rate of PICC secondary displacement removal,the incidence of complications related to PICC secondary displacement,and the average length of stay of the infants were compared between the 2 groups. Results Ultimately,60 cases were included in each of the 2 groups. The incidence of secondary ectopic PICC in the post-intervention experimental group was 8.33%,lower of 23.33% in the control group;the extubation rate of secondary ectopic PICC was 3.33%,lower of 16.67% in the control group;the incidence of complications related to secondary ectopic PICC was 13.33%,lower of 51.67% in the control group;the average hospitalization day was 50(48,55)d,shorter of 61(55,65)d in the control group. The difference between the 2 groups was statistically significant(P<0.05). Conclusion The combination of bedside ultrasound and joint movement protractor was used to accurately monitor and manage the range of motion of limbs in children with upper limb catheterization,which effectively guaranteed the safe position of the catheter tip and reduced the incidence of secondary ectopic complications related to PICC. It can be further promoted and applied in clinical practice.

    Safe medication nursing care for a patient with treatment resistant depression
    ZHANG Qi, SHI Zhongying, LI Li, LI Hua, YIN Ying, HU Yan, CUI Lüchun
    2025, 60(17):  2069-2072.  DOI: 10.3761/j.issn.0254-1769.2025.17.004
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    This case report summarizes the nursing experience in ensuring medication safety during intranasal esketamine spray treatment for a patient with treatment-resistant depression. Key nursing interventions included:pre-treatment assessment of concomitant medication risks,preparation of staff,environment,and medications;during treatment,strict adherence to administration protocols with simultaneous respiratory function monitoring and nasal tolerability assessment to minimize respiratory depression risk;post-treatment blood pressure surveillance combined with longitudinal symptom tracking and dynamic suicide risk evaluation for self-harm prevention;reinforcement of adverse reaction prevention and management. After completing the full 4-week treatment course(8 sessions),the patient exhibited the improved depressive symptoms and the reduced suicidal ideation,and the patient was successfully discharged.

    Research progress of wearable flexible devices in nursing safety management
    SHEN Zhiying, LI Chengyuan, WANG Sha, DONG Xiaoqian, XIE Jianfei
    2025, 60(17):  2073-2078.  DOI: 10.3761/j.issn.0254-1769.2025.17.005
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    Nursing safety management is crucial to patient health outcomes,and real-time monitoring and early warning systems play a vital role in enhancing nursing safety and reducing medical incidents. Wearable flexible devices enable non-invasive,continuous monitoring of various physiological parameters and provide timely alerts. These devices not only improve the efficiency and quality of nursing safety management but also offer patients more convenient,accurate,and personalized care services. This article provides a comprehensive review of the application of wearable flexible devices in nursing safety management,examining their application scenarios,advantages,and challenges,and offering insights to facilitate the further integration of this technology into nursing safety practices.

    Specialist Nursing Practice and Research
    Study on the effect of home-based cardiac rehabilitation adherence in patients undergoing transcatheter aortic valve replacement based on mobile healthcare
    JIA Yingying, WANG Ya, WANG Hongxing, SONG Jianping
    2025, 60(17):  2079-2086.  DOI: 10.3761/j.issn.0254-1769.2025.17.006
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    Objective To construct a home cardiac rehabilitation program based on mobile healthcare for patients undergoing transcatheter aortic valve replacement(TAVR) and validate its application effectiveness. Methods Based on the best evidence summary,using the Behavior Change Wheel as a framework,15 experts from relevant fields were invited for the Delphi expert consultation to construct a home-based cardiac rehabilitation program and develop an intervention system. Using convenience sampling method,72 patients from a tertiary hospital in Zhejiang Province from January to March 2024 were selected as research subjects,and the intervention was implemented from June to August 2024. They were randomly divided into an experimental group and a control group using a random number table method,with 36 cases in each group. The experimental group received a home rehabilitation program based on mobile healthcare on the basis of routine care,while the control group received routine care. The differences in outcome indicators were compared between 2 groups of patients after 12 weeks of intervention. Results The expert authority coefficients for the 2 rounds of Delphi expert inquiry were 0.95,and Kendall’s W were 0.591 and 0.414,respectively(P<0.001). The final draft of the intervention plan includes 6 primary indicators,14 secondary indicators,and 25 tertiary indicators. A total of 70 patients completed the intervention,with 35 in the experimental group and 35 in the control group. Before intervention,there was no statistically significant difference in home cardiac rehabilitation exercise compliance,frailty,and activities of daily living ability between the 2 groups(P>0.05). After 12 weeks of intervention,the scores of the home-based cardiac rehabilitation exercise adherence scale in the experimental group improved compared to the control group(Z=-7.203,P<0.001). Conclusion The home rehabilitation program for TAVR patients based on mobile healthcare is scientific and feasible,and can effectively improve patients’ exercise compliance with home cardiac rehabilitation. In the future,the rehabilitation program and the system can be continuously optimized in the clinical application to improve patient prognosis.

    A mixed-methods study on the current status of post-traumatic growth and influencing factors among family caregivers of older adults with dementia
    WANG Yang, GU Yanhong, LONG Dechao, WANG Junqiao
    2025, 60(17):  2087-2094.  DOI: 10.3761/j.issn.0254-1769.2025.17.007
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    Objective To describe the current status of post-traumatic growth among family caregivers of dementia and analyze its influencing factors to provide a reference for the development of post-traumatic growth interventions. Methods A convergent mixed-methods study was adopted. Family caregivers of older adults with dementia who were outpatients at a tertiary hospital and a mental health center in Shanghai from May to December 2024 were conveniently selected for the study. A general information questionnaire,the Chinese-Posttraumatic Growth Inventory,the Simplified Coping Style Questionnaire,the Simplified Chinese Event Related Rumination Inventory,the Connor-Davidson Resilience Scale,and the Social Support Rating Scale were used for data collection. The survey was conducted,and the data were analyzed using multivariate stepwise linear regression. 19 family caregivers of dementia patients were interviewed in a semi-structured manner using purposive sampling,and the interview data were analyzed using directed content analysis. Results The dementia family caregivers’ post-traumatic growth score was(64.73 ± 11.43). The regression results showed that patients’ dementia type,types of comorbid chronic diseases,knowledge of the disease,deliberate rumination,positive coping styles,psychological resilience,and social support were the influencing factors of post-traumatic growth(P<0.05). Qualitative results:interviews refined 8 themes based on 3 dimensions,including individual factors,family and social factors,and cultural and environmental factors. The integration results indicate that both quantitative and qualitative findings were validated and complemented. Conclusion Dementia family caregivers’ post-traumatic growth is low to moderate,and the influencing factors are associated with 3 aspects,namely patient factors,caregiver factors,and socio-cultural factors. Healthcare professionals should pay attention to caregivers’ post-traumatic growth and develop personalized interventions based on influencing factors,enhancing their level of post-traumatic growth.

    Development and verification of a risk prediction model for social dysfunction in middle-aged and elderly patients with ischemic stroke
    MAO Meiqi, LIU Yao, HAO Yang, ZHAO Yaning, QIN Yanmei, HAN Ying
    2025, 60(17):  2095-2101.  DOI: 10.3761/j.issn.0254-1769.2025.17.008
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    Objective To develop and validate a risk prediction model for social dysfunction in middle-aged and elderly patients with ischemic stroke. Methods A non-matched case-control study was conducted among ischemic stroke patients admitted to the neurology department of a tertiary hospital in Tangshan between August 2022 and March 2023. Patients who developed social dysfunction within 3 months after discharge were assigned to a case group,while those without it were assigned to a control group. Multivariate logistic regression was used to identify significant predictors and construct a nomogram-based prediction model. The model’s discrimination and calibration were assessed using the area under the receiver operating characteristic curve(AUC) and the Hosmer-Lemeshow test. Internal validation was performed via bootstrap resampling,and clinical utility was evaluated using decision curve analysis. Results Logistic regression identified the following as significant risk factors for social dysfunction(P<0.05):male gender,age ≥60 years,primary education or below,rural residence,income<3 000,cognitive impairment,low disability acceptance,poor self-management ability,suboptimal utilization of chronic disease resources,low future-oriented coping,and high cumulative ecological risk. The nomogram achieved an AUC of 0.874,with a sensitivity of 79.4% and specificity of 80.7%. The Hosmer-Lemeshow test indicated good calibration(χ2=3.631,P=0.88). Conclusion The developed nomogram provides an effective tool for predicting the risk of social dysfunction in middle-aged and elderly ischemic stroke patients,facilitating early identification of high-risk individuals.

    Construction and application of a graded early mobility path for critically ill adult patients
    LI Bing, TANG Sheng, MA Yanlan, SHEN Lingyu, ZHAO Qinghua, LUO Ping, BI Mengjie
    2025, 60(17):  2102-2109.  DOI: 10.3761/j.issn.0254-1769.2025.17.009
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    Objective To develop a graded early mobility implementation pathway for critically ill adult patients in tertiary hospitals in Beijing and to preliminarily validate its feasibility and effectiveness. Methods Based on the “goal-directed” early mobility concept,a graded early mobility implementation pathway for critically ill patients was developed through evidence synthesis and the Delphi method,consisting of 3 components:patient inclusion,mobility implementation,and mobility evaluation. Using convenience sampling,patients meeting inclusion criteria in the general ICU of a tertiary hospital in Beijing from October 2024 to January 2025 were selected as participants. Among them,25 patients admitted from December 2024 to January 2025 were assigned to an experimental group and received early mobility interventions following the developed pathway. 25 patients admitted from October to November 2024 served as a control group and received routine ICU mobility care. Outcomes including diaphragm excursion,muscle strength,ICU length of stay,and adverse events were compared between the 2 groups. Results The graded early mobility pathway achieved an implementation rate of 70.05% in the experimental group,significantly higher than it in the control group(P<0.001),without increasing adverse events. Post-intervention diaphragm excursion in the experimental group was significantly greater than that in the control group(P=0.018). Conclusion The developed graded early mobility implementation pathway for ICU patients demonstrates scientific rigor and clinical practicality. It provides a reference for the widespread and effective implementation of early mobility in ICUs,standardizing its clinical application.

    Latent profile analysis and influencing factors of symptom burden among stroke patients
    ZHANG Shiqing, XU Xuejun, DENG Man, YANG Yue, LI Min, YANG Xiumu
    2025, 60(17):  2110-2117.  DOI: 10.3761/j.issn.0254-1769.2025.17.010
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    Objective To explore the potential profiles of symptom burden among stroke patients and to analyze the differences in the characteristics of different classes of stroke patients,providing references for clinical nursing practice. Methods A convenience sampling method was used to select 485 stroke patients treated at 4 tertiary-level general hospitals in Anhui Province from July to December 2024 as the study population. The general information questionnaire,Stroke Symptom Cluster Scale,Personal Mastery Scale,and Cognitive Reserve Index questionnaire. Latent profile analysis was employed to explore the categories of symptom burden among stroke patients,and multiple logistic regression was used to assess the influence factors of each category. Results A total of 456 valid questionnaires were collected,with a valid response rate of 94.02%. Symptom burden among stroke patients can be divided into 4 latent profiles:low symptom burden group (69.08%),multiple symptom burden group(8.12%),moderate burden-physical activity impairment group(11.18%),and moderate burden-emotional and cognitive language impairment group(11.62%). The patient’s age,number of stroke episodes,number of chronic diseases,systemic inflammation response index,personal mastery,and cognitive reserve were the factors influencing the latent profiles of symptom burden in stroke patients(P<0.05). Conclusion The symptom burden of stroke patients shows significant heterogeneity. Medical staff can develop targeted nursing interventions based on the category characteristics and influencing factors of the symptom burden in stroke patients.

    The status and influencing factors of type 2 diabetes mellitus patients’ fear of complications
    LIU Yuqin, HUO Guixia, LI Shaobo, LI Yumin, LU Yunpeng, ZHANG Zichen, DU Qiuhui, NI Mengdi, LIU Farong, JIA Honghong
    2025, 60(17):  2118-2123.  DOI: 10.3761/j.issn.0254-1769.2025.17.011
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    Objective To investigate the status and influencing factors of type 2 diabetes mellitus(T2DM) patients’ fear of complications,and to provide a reference for formulating targeted intervention measures. Methods From April to November 2024,370 patients with T2DM in 2 tertiary general hospitals in Daqing City were selected by convenience sampling method. General data questionnaire,Fear of Complications Questionnaire,Self-Perceived Burden Scale,Psychological Capital Questionnaire,Mishel Uncertainty in Illness Scale and Family Apgar Index Questionnaire were used for investigation. Univariate analysis and binary Logistic regression were performed to analyze the influencing factors. Results A total of 364 valid questionnaires were collected,with an effective recovery rate of 98.38%. The score of Fear of Complications Questionnaire was(23.47±7.47),and the incidence of fear of complications was 22.25%. Logistic regression analysis showed that medical payment methods,the number of complications,positive psychological capital and family care were the influencing factors of FoC in T2DM patients. Conclusion The fear of complications in T2DM patients is at a moderate level. Nursing staff should pay attention to the early assessment of patients’ fear of complications,promptly identify and take effective measures to reduce the level of patients’ fear of complications,improve their quality of life.

    Enteral and Parenteral Nutrition
    Mapping the nutritional management journey of homebound patients after gastric cancer surgery and nursing countermeasures
    FAN Yuqing, XI Zuyang, WEI Yongting, TIAN Fei, NI Fu, DONG Xiaoqian, QIN Jiemin
    2025, 60(17):  2124-2130.  DOI: 10.3761/j.issn.0254-1769.2025.17.012
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    Objective To identify the multidimensional needs of postoperative gastric cancer patients for home-based nutritional management based on patient journey maps,and to provide a reference for carrying out nutritional management interventions. Methods Using descriptive qualitative research methods,we facilitated semi-structured in-depth interviews with 9 pairs of postoperative gastric cancer homebound patients and their primary caregivers from a tertiary general hospital in Yichang City,China,from September 2024 to January 2025,and analysed the data and drew the patient journey maps by content analysis. Results Totally 24 sub-themes were summarised from 4 aspects,namely tasks,emotions,pain points and opportunity points,and journey maps involving the acute recovery period,the transitional adaptation period and the nutritional reconstruction period were formed. Conclusion The nutritional needs of homebound patients after gastric cancer surgery are complex and variable,and their needs for dietary guidance,eating-related symptom management,and real-time counselling are highlighted. In the future,appropriate intervention strategies can be developed based on the journey maps to meet the multidimensional nutritional needs of patients.

    The experience of exclusion diet in children with Crohn’s disease and their parents:a qualitative study
    WEI Lijuan, HUANG Jialin, YANG Huan, ZHANG Miaoxian, ZHANG Chaomi, GENG Lanlan, XIONG Liya, LIU Liying
    2025, 60(17):  2131-2136.  DOI: 10.3761/j.issn.0254-1769.2025.17.013
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    Objective To explore the experiences of children with Crohn’s disease and their parents regarding the exclusion diet,and to provide a basis for formulating personalized dietary guidance programs. Methods A total of 12 children with Crohn’s disease and their parents,hospitalized in the Department of Gastroenterology at a tertiary children’s hospital in Guangzhou from June to December 2023,were selected as research subjects using objective sampling. Semi-structured interviews were conducted,and the data were analyzed and refined using Colaizzi’s seven-step analysis method. Results Totally 3 themes and 14 sub-themes were extracted. ①Lack of cognition and trust in Crohn’s disease exclusion diet(unfamiliarity with the contents of the diet,misunderstanding of the diet’s preparation,inadequate response to daily exclusion diet practices,parents’ distrust in the exclusion diet). ②The practical challenges of the Crohn’s disease exclusion diet(the challenge of personal dietary preferences,the challenge of family meal preparation,the challenge of school feeding,food intolerance,feelings of monotony and weariness following the exclusion diet). ③Innovations in practicing the Crohn’s disease exclusion diet (managing taste fatigue,managing visual fatigue,innovative cooking methods,prioritizing exclusive enteral nutrition followed by the exclusion diet,overcoming the desire for universal food). Conclusion Children with Crohn’s disease and their parents exhibit insufficient cognition and trust in the exclusion diet and face various challenges in practice. Clinical medical staff should adopt personalized coping strategies tailored to the specific circumstances of each child.

    Rare Disease and Critical Care
    Nursing care of 2 heart or lung transplant patients with walking rehabilitation training assisted by extracorporeal membrane oxygenation before surgery
    WANG Jinning, PAN Xiangying, CHEN Chenkan, JIN Jiajia, LI Jia
    2025, 60(17):  2137-2140.  DOI: 10.3761/j.issn.0254-1769.2025.17.014
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    To summarize the nursing experience of walking rehabilitation training assisted by extracorporeal membrane oxygenation in 2 cases of heart or lung transplant patients before surgery. The main points of nursing care:to set up a multidisciplinary team to formulate a rehabilitation exercise program;phased rehabilitation exercise to improve the preparation of body functions before walking training;multi-dimensional safety management to prevent and deal with walking training-related complications;to strengthen the assessment and monitoring,and implement personalized nutritional programs;to carry out positive psychological interventions to alleviate the anxiety. After undergoing active treatment and care,and after 3 d and 6 d of walking exercise assisted by extracorporeal membrane oxygenation,respectively,both of them finally underwent organ transplantation successfully,recovered well after the operation,and were transferred to the general ward to continue treatment.

    Nursing care of Takotsubo syndrome in an elderly patient after mitral valve replacement surgery:a case study
    GU Xiaolin, ZHANG Chongjian, ZENG Liruo, LI Jie, CHEN Yuqin
    2025, 60(17):  2141-2144.  DOI: 10.3761/j.issn.0254-1769.2025.17.015
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    This study summarizes the nursing experience of an elderly patient who developed Takotsubo syndrome following mitral valve replacement surgery. Key nursing points include:close monitoring of electrocardiogram and myocardial enzyme spectrum changes for early identification of Takotsubo syndrome;implementation of a multi-dimensional collaborative circulatory support strategy;establishment of a triadic psychological intervention model comprising “environment-communication-family support” to prevent the exacerbation of Takotsubo syndrome based on stressor management;application of multimodal early rehabilitation interventions to shorten mechanical ventilation duration. After meticulous treatment and care,the left ventricular ejection fraction (LVEF) of the patient improved to 46% on postoperative day 12. There were no occurrences of malignant arrhythmias or multiple organ dysfunction. On postoperative day 16,the patient was transferred to a general ward for continued specialized treatment,and on postoperative day 22,the patient was successfully discharged after rehabilitation.

    Nursing care for a patient with extremely severe obese and multiple myeloma complicated with status epilepticus
    CAO Xiaobai, WANG Pengju, GAO Lan, WANG Yujiao
    2025, 60(17):  2145-2149.  DOI: 10.3761/j.issn.0254-1769.2025.17.016
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    To summarize the nursing care for a patient with extremely severe obese and multiple myeloma complicated with status epilepticus. The key points of nursing include:a multidisciplinary rescue team was established to accurately and comprehensively assess the patient’s obesity level;based on the degree of obesity,a goal-directed sedation and analgesia strategy was implemented;airway management measures were optimized for difficult intubation,and lung-protective ventilation strategies were strictly followed with adjusted mechanical ventilation parameters;implementing precise fluid management,closely monitoring electrolyte levels,and reducing triggers for seizure episodes;sequential nutrition support combined with trophic feeding was provided,along with personalized enteral nutrition;early mobilization was initiated to prevent deep vein thrombosis;a skin protection strategy was implemented to establish a safe skin barrier. After meticulous treatment and nursing care,the patient’s condition improved,and she was discharged.

    Evidence Synthesis Research
    Virtual reality for post-stroke limb rehabilitation:an overview of systematic reviews
    YANG Hongwei, WANG Juan, JI Hui, LI Zhongjian, LAN Binghua, LI Xueying
    2025, 60(17):  2150-2157.  DOI: 10.3761/j.issn.0254-1769.2025.17.017
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    Objective To re-evaluate systematic reviews on the application of virtual reality(VR) technology in limb rehabilitation for stroke patients,providing evidence to support the implementation of VR. Methods Systematic searches were conducted in Web of Science,PubMed,CINAHL,Cochrane Library,Embase,CNKI,CBM,WanFang,and VIP databases from their inception until March 2025,identifying systematic reviews/meta-analyses investigating VR for limb rehabilitation in stroke patients. 2 researchers independently screened the literature. Methodological quality was evaluated using the Assessment of Mutiple System Reviews 2(AMSTAR 2) tool;reporting quality was evaluated according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) guidelines;evidence quality was graded using the Grades of Recommendations Assessment,Development,and Evaluation(GRADE) system;literature overlap was assessed using the Corrected Covered Area(CCA) method. Results A total of 15 articles were included. According to AMSTAR 2,totally 3 reviews were of moderate quality,while the remainder were rated as low or very low quality. PRISMA scores ranged from 19.5 to 27.0 points. Based on GRADE,a review was classified as high quality,6 as moderate quality,and the remainder as low or very low quality. The CCA was 5.3%,indicating slight overlap. Conclusion VR contributes to the improvement of indicators such as upper limb motor function/mobility and lower limb balance in stroke patients. However,methodological limitations,including weak control of bias and inadequate handling of heterogeneity among included studies,restrict the overall quality of evidence. Further standardized,high-quality studies are needed to provide more reliable evidence to support clinical decision-making.

    Summary of the best evidence for blood glucose monitoring and management in patients with diabetes of the exocrine pancreas
    HU Chenlu, PEI Xiangru, ZHANG Lifei, FU Hongxing, JIN Jingfen
    2025, 60(17):  2158-2164.  DOI: 10.3761/j.issn.0254-1769.2025.17.018
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    Objective To retrieve,evaluate and summarize the best evidence for blood glucose monitoring and management in patients with diabetes of the exocrine pancreas(DEP),and to provide evidence-based basis for clinical practice. Methods According to the “6S” evidence model,relevant evidence on blood glucose management in patients with DEP was searched from computer decision support systems,guideline networks,professional association websites and databases from top to bottom,covering clinical decision-making,clinical practice guidelines,evidence summaries,systematic reviews,expert consensuses,and randomized controlled trials. The search scope was from the establishment of the databases to June 30,2024. Totally 2 researchers independently evaluated the quality of the included literature,and extracted data and summarized evidence that met the criteria. Results A total of 10 articles were included,including 3 guidelines,1 expert consensus,2 systematic reviews,1 clinical decision,1 RCT,and 2 cohort studies. Finally,26 pieces of best evidence were formed from 5 aspects,including blood glucose management team construction and goals,blood glucose monitoring methods,glucose control medication management,lifestyle health education and treatment of hypoglycemia. Conclusion This study summarizes the best evidence for blood glucose monitoring and management in DEP patients,which can provide resource preparation for clinical translation and a basis for medical staff to carry out blood glucose management in DEP patients.

    Review
    Burden of family caregivers for hemodialysis patients:a scoping review
    LI Tiantian, CUI Liping, WEI Ling, WANG Ling, QU Nan, ZHANG Yang, ZHANG Lifeng
    2025, 60(17):  2165-2171.  DOI: 10.3761/j.issn.0254-1769.2025.17.019
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    Objective A scoping review of studies related to the burden on family carers of haemodialysis patients was conducted with the aim of comprehensively dissecting the current state of research in this area and informing subsequent studies. Methods A scope review reporting framework was used to search the CNKI,China Biomedical Literature Database,Vip Database,Wanfang Database,Chinese Medical Journal Full Text Database,PubMed,CINAHL,Web of Science,Cochrane Library,Scopus,and Embase,with a timeframe for searching the database from its construction to 29 March 2025. The included literature was summarised and analysed. Results A total of 25 papers were included,of which 21 reported scores/incidence of family carer burden,with overall results dominated by mild to moderate burden,involving 5 tools for assessing family carer burden,influencing factors (including demographic,disease-related,psychosocial,economic social,caregiving factors) and 6 other aspects. Intervention covers peer support groups,the 5-A model of self-management,health behaviours teaching,problem-focused strategies,etc. Conclusion The burden of family caregivers of haemodialysis patients at home and abroad is a common problem,which is affected by many factors,and it is urgent to carry out multi-centre,large-sample longitudinal studies and family-centred intervention studies in the future,so as to reduce the adverse effects of the burden of family caregivers,and to improve the patients’ adherence to the treatment as well as the physical and mental health of the family caregivers.

    Research progress and enlightenment on the construction and management of virtual wards abroad
    SONG Wenshuai, WANG Suyun, CUI Hongbing, JI Youran, GONG Xuan
    2025, 60(17):  2172-2176.  DOI: 10.3761/j.issn.0254-1769.2025.17.020
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    With the increasing incidence of chronic diseases,the research is conducted to actively explore out of hospital management models for chronic disease patients globally. Among them,virtual ward is a management model based on multidisciplinary team collaboration to provide professional medical and nursing services for unplanned hospitalization high-risk population. This model not only facilitates the transition of patients from inpatient settings to home environments,improving disease prognosis and reducing hospitalization risk,but also alleviates the bed burden on large hospitals. This article provides a review of the concept,development,construction of the operational system,and patient management processes of virtual wards,and offers insights and suggestions to provide references for the optimization and development of out of hospital management models for chronic disease patients in China.