The nursing alliance， through the construction of a nursing service system， can achieve division of labor and collaboration within the alliance as well as integration of high-quality nursing resources，ultimately realizing the goal of sharing high-quality nursing resources.This article reviews the experience of constructing and practicing nursing consortium， and summarizes the achievements of nursing consortium in optimizing nursing resource allocation， promoting the development of specialized nursing， improving grassroots nursing level， and achieving regional information sharing， in order to provide reference for the improvement and further development of nursing consortium in the future.
The problem of hypoglycemia caused by primary hepatic carcinoma （HPC） is increasingly prominent in clinical treatment and nursing work.The care of patients with hypoglycemia of PHC is an important part of clinical management and has positive significance for improving the quality of life.At present at home and abroad is still lack of PHC hypoglycemia patients care expert consensus or guidelines， in order to further standardize the blood glucose management of patients with hypoglycemia of PHC， Guangdong nurses association， physician association joint organization related experts， focus on the assessment to patients with hypoglycemia of PHC and screening， prevention and monitoring， intervention and home care， etc.， eventually form the patients with hypoglycemia of PHC nursing management expert consensus， in order to provide scientific and systematic for clinical nursing guidance.
To use data-driven method for feature screening and establish a moderate to severe pain risk prediction model after microwave ablation of liver cancer.
Methods
A total of 239 patients undergoing microwave ablation of hepatoma under local anesthesia who were hospitalized in the Department of Interventional Oncology Affiliated to Guangxi Medical University from January 2018 to December 2023 were selected as the study objects， and were divided into mild pain group and moderate to severe pain group according to postoperative pain scale （VAS）.LASSO model was used to screen the characteristics of pain after microwave ablation of liver cancer， and a prediction model was constructed.The prediction model was internally verified by bootstrap resampling method.
Results
126 of the 239 patients had moderate to severe pain after surgery， and the incidence of moderate to severe pain was 52.72%.Based on the data driven feature screening results， Age， sex， cirrhosis， primary disease， Child-Pugh grade， previous surgery，lesion diameter， number of lesions， distance from liver envelope， ablation time， pain disaster， anxiety and depression were included as predictors of moderate to severe pain after microwave ablation of liver cancer.Internal verification by Bootstrap method showed that the average areaunder ROC curve （AUC） was 0.978，C-Index was 0.978， AUC was 0.882， model specificity was 0.941，and sensitivity was 0.792.Based on the above results， the nomogram of moderate and severe postoperative pain was constructed.
Conclusion
The verification results show that the calibration and differentiation of the model are good，and the moderate and severe pain nomogram based on this model has good predictive efficacy and clinical application value.
To construct and verify a predictive model for evaluating the pain risk of patients with liver cancer after transcatheter hepatic arterial chemoembolization （TACE）.
Methods
The clinical data of 212 patients with liver cancer who received TACE in a first-class hospital in Guangzhou from January 2022 to December 2023 were collected retrospectively.These patients were divided into pain group and pain-free group according to whether they experienced pain after operation.Logistic regression method was used to screen the key factors causing pain after TACE， and a nomogram was created to predict the pain risk.Bootstrap technology is used to verify the prediction model internally， and C- statistics and calibration curve are used to evaluate its prediction effect.
Results
Among the 212 patients with liver cancer treated by TACE， 74 patients had postoperative pain， and the incidence of pain was 34.9%.It was found that patients with a history of liver cirrhosis had higher independent risk factors for pain after TACE （P＜0.05）， while the use of painkillers before and during the operation significantly reduced the risk of postoperative pain （P＜0.05）.Based on this， a prediction model of postoperative pain risk of patients with liver cancer was established， and the formula was Logit（P） = 62.39 + 1.676× ［liver cirrhosis］ - 1.643×［analgesic used before operation］ - 1.293×［analgesic used during operation］.The C statistic of this model is 0.729 （95%CI： 0.661～0.795）， the sensitivity is 45.8%， and the specificity is 70.0%.The calibration curve and Brier score verify the good fitting degree of the model.
Conclusion
In this study， a pain prediction model for patients with liver cancer after TACE was established， which showed good discrimination and calibration， and provided a reliable tool for clinic experience.
To analyze the application effect of clinical nursing pathways in patients undergoing intervention through the femoral artery approach.
Methods
I Collect interventional patients who underwent femoral artery puncture in our hospital from March to November 2023， and divide them into a control group and a study group based on voluntary sampling principles.A total of 179 patients in the control group received routine nursing care， while 178 patients in the study group received clinical nursing care through clinical nursing pathways.
Results
Compared with the control group， the study group showed a significant decrease in bleeding incidence， puncture pressure time， and limb immobilization time （P＜0.05），as well as a significant decrease in gastrointestinal bloating and lower limb numbness （P＜0.05）.However，there was no improvement in the incidence of difficulty urinating and sleep disorders （P＞0.05）.
Conclusion
The application of clinical nursing pathways in interventional patients after femoral artery puncture can help reduce the incidence of bleeding， decrease the time of finger pressure at the puncture site， and reduce the patient's bed rest time.It is worth promoting and applying.
To establish an evaluation system for core competence of interventional specialist nurses， in order to provide an objective and scientific evaluation tool and reference for the training，management， and assessment of interventional specialist nurses.
Methods
A preliminary index framework for core competence evaluation of interventional specialist nurses was developed through literature review，semi-structured interview， and other methods， and an expert letter questionnaire was generated.Through two rounds of Delphi expert consultation with 15 experts through letters， the evaluation indexes for core competence of interventional specialist nurses were revised and optimized.
Results
The repsonse rates of the two rounds of Delphi expert consultation were both 100%.The percentages of experts giving opinions were 60% and 6.7%， respectively.The authority coefficient of expert consultation was 0.85.An evaluation system for core competence of interventional specialist nurses was established， which included 9 first-level indexes and 25 second-level indexes.
Conclusion
The established evaluation system for core competence of interventional specialist nurses is highly practical and scientific， which can provide an effective basis for the assessment and management of the core competence of interventional specialist nurses， constantly improve the core competence of interventional nurses， and promote the deepening and refinement of the core competence evaluation system for nurses.
This study aimed to describe the disease experience and needs of patients with cancer-associated thromboembolism （CAT）， in order to provide a basis for the development of effective intervention programs.
Methods
A descriptive qualitative design was used， a purposive sample of 12 patients with CAT in a top 3 hospital in Nantong were selected for semi-structured in-depth interviews from January to June 2023， content analysis was adopted to analyze the data.
Results
The experiences and needs of CAT patients can be summarized into four themes： heavy burden of disease symptoms （many symptomatic disturbances， predominantly negative emotions）； individual differences in disease coping strategies （conflict in treatment decision-making、acceptance and debugging， passive avoidance）； deficiencies in disease self-management （insufficient knowledge of the disease、weak sense of self-advocacy， barriers to communication）； longing for support （needs for information support for the disease， needs to resolve doctor-patient communication barriers， needs to strengthen psychological assistance、needs for community medical and health services）.
Conclusion
This study found that CAT patients face many problems such as high symptom burden and psychological barriers in the process of coping with illness， and their needs cannot be met in time.Healthcare professionals should pay close attention to the characteristics and needs of these patients in coping with illness， and provide targeted intervention and improvement strategies to improve their ability to cope with illness and their quality of life.
To investigate the implementation of the three major command and dispatch processes of emergency care for out-of-hospital cardiac arrest （OHCA） patients in the central urban area of Chengdu， including alarm reception， dispatch， and pre-hospital telephone guidance， and to analyze the reasons and propose targeted improvement measures.
Methods
The data of 85 patients who were diagnosed as having “cardiac arrest” by Chengdu 120 pre-hospital emergency doctors on the scene from September 1， 2021 to August 30， 2023 were retrospectively analyzed， and analyze the effect of the accuracy of reasons for calling for help on the emergency response time.A questionnaire survey was conducted on 147 Chengdu 120 dispatchers and 2309 pre-hospital emergency personnel of municipal network hospitals，and relevant data were analyzed.
Results
With regard to alarm reception， for patients with cardiac arrest，the reasons for calling for help can be divided into three kinds： syncope， coma， and cardiac and respiratory arrest/death.There was a significant difference in the length of first aid response and the length of time of arriving at the scene among different reasons for calling for help （P=0.002）， and both were shorter in the cardiac and respiratory arrest/death group.Regarding dispatch， there was a significant difference in the perceived importance of scheduling principles between dispatchers and pre-hospital emergency personnel（P＜0.001）， with a significantly higher percentage of pre-hospital emergency personnel believing that meeting professional needs was most important at 11.35% （P=0.026）.For pre-hospital telephone guidance， 65.31% of dispatchers provided telephone guidance for hands-only cardiopulmonary resuscitation （CPR）， while 83.67%did not provide guidance on automated external defibrillator （AED） usage.The rate of telephone guidance rose with age.
Conclusion
Dispatchers should use faster and more effective communication methods and improve the recognition rate of OHCA by guiding the judgment of bystanders to more accurately understand the cause of the call to the emergency personnel； dispatchers should flexibly apply the dispatch principles according to the actual situation； and measures need to be taken to improve the rate of telephone guidance for CPR by dispatchers from different perspectives.
To explore the curative effect of a modified reading-man flap on sacrococcygeal pressure sore.
Methods
From October 2022 to May 2023， 11 patients with pressure ulcers received modified reading-man flap repair at Shougang Hospital of Peking University.There were 8 males and 3 females.The patients ranged in age from 36 to 78 years old， with an average age of 56.5 years old.All the pressure sores were located in the sacrococcygeal region.The average size of the pressure sores was 12.0 cm × 9.0 cm， and the defect area ranged from 10.0 cm × 7.0 cm to 21.0 cm × 16.0 cm.
Results
All the 11 cases of skin flap survived completely， and all achieved healing， good texture， and color.After 2 to 6 months of follow-up， there was no recurrence of pressure ulcers and the degree of scar was mild.All the 11 patients were very satisfied with the operation results.
Conclusion
The modified reading-man flap is an effective method for repairing the wound of pressure ulcer.The operation of the flap is simple and the survival rate of the flap is high.
Scholars both domestically and internationally have proposed different variations of the celiac axis （CA） and various typing methods.However， each method has its own advantages and disadvantages， making it challenging to establish a unified typing system.In this study， the anatomical variations of each branch of the CA were observed using multi-slice CT angiography.A new CA classification was proposed， and the clinical implications of this novel classification in treatment was investigated.
Methods
The clinical data of 747 patients who underwent abdominal multi-slice CT angiography for vascular imaging from August 2020 to December 2022 were retrospectively analyzed.The selected threedimensional reconstruction images of the CA were observed to analyze and summarize the variations of its branches.Data statistics were conducted on the various variations， and a new classification method for CA was proposed.
Results
A total of 747 samples were analyzed using the new classification method.This classification system categorizes CA into three main types： I， II， and III.Each main type further consists of two subtypes， resulting in a total of six subtypes.These subtypes are Ia， Ib， IIa， IIb， IIIa， and IIIb.Among the samples， there were 696 cases of type I， which accounted for 93.2% of the total （696/747）.Type Ia comprised 555 cases， representing 74.3% （555/747）， with 369 males and 186 females.Type Ib accounted for 141 cases， making up 18.9% （141/747）， with 95 males and 46 females.Type II had 50 cases， corresponding to 6.7% （50/747）.Type IIa had 46 cases， accounting for 6.2% （46/747）， including 34 males and 12 females.Type IIb had 4 cases， making up 0.5% （4/747）， with 3 males and 1 female.There was only 1 case of type III， representing 0.1% （1/747）.This case was a male.There were no cases of type IIIa， but there was 1 case of type IIIb， accounting for 0.1% （1/747）.The extra arteries with the highest proportion in the sample were the inferior phrenic artery （IPA）， dorsal pancreatic artery （DPA）， and superior mesenteric artery （SMA）.
Conclusion
The CA exhibits high variation.The new celiac axis classification， based on multi-slice spiral CT， is straightforward and easy to remember， providing valuable guidance for clinical surgery.
To evaluate the clinical outcomes of surgery using a novel medial and lateral hook locking plate in the treatment of complex tibial plateau fractures.
Methods
From July 2017 to April 2019， 10 cases of complex tibial plateau fractures were treated surgically using a novel medial and lateral hook locking plate.
Results
The 10 patients were followed for 8～12 months， with an average of 9.5 months.The mean time of union was 4.8 months （range， 4～6 months）.At the last follow-up， no unstability occurred， and the mean range of motion of the knee was 0.1° in extension and flexion 123.5° in flexion.The mean Oxford score was 39.7 points， and the mean HSS score was 89.3 points.
Conclusion
Surgical treatment of complex tibial plateau fractures with the novel medial and lateral hook locking plate can not only make internal fixation more suitable in different individuals， but also reduce iatrogenic injuries and medical cost，with satisfactory clinical results.
To explore the overall knowledge structure， global research status， and development trends of core decompression for femoral head necrosis.Based on cases in our center， the clinical efficacy and value of this surgical technique were verified.
Methods
Relevant literatures on core decompression for osteonecrosis of the femoral head were searched through the Web of Science core collection database， with a time span from database establishment to January 1， 2024.VOSviewer and Scimago software were used to analyze the co authorship status， regional distribution of research results， hot topics， and time zone distribution of research hotspots in the field of core decompression technology in the treatment of osteonecrosis of the femoral head.And we generated a visual knowledge graph.The current status and development trends of hip preservation therapy for necrosis of the femoral head were comprehensively evaluated， and bibliometric results were correlated with the real-world data.A retrospective analysis was conducted on 27 patients with ARCO stage I-IIIA who underwent simple core decompression or core decompression combined with bone grafting in our hospital from October 2017 to June 2023.We compare the visual analog scale （VAS） and Harris hip joint score in patients undergoing unilateral core decompression combined with bone grafting before surgery， 3 months after surgery， and at the last follow-up after surgery.And we evaluate the collapse of the femoral head based on preoperative and postoperative X-ray， and evaluate the situation of reoperation.
Results
This study included 859 academic papers and reviews， with Chinese scholars having the highest total number of publications， followed by American scholars.However， American scholars Mont and Michael A.had the highest number of individual publications （41）， while American scholars Hungerford ds.had the highest number of citations （178.5 per article）.The top 10 research institutions in terms of publication volume have the highest number of Chinese institutions， but the articles published by Sinai Hospital have been cited 101.13 times， which is more recognized by the academic community.Keyword analysis suggests that the current research focus is not limited to the study of core decompression technology itself， but more on the selection of bone grafting materials and the study of cell therapy.Core decompression combined with bone grafting and cell therapy is currently a hot topic.A total of 27 patients with femoral head necrosis were included as the study subjects in this study， with a total of 32 hip joints undergoing core decompression surgery.Among them， 14 hip joints underwent simple core decompression surgery， and 18 hip joints underwent core decompression combined with bone grafting surgery.Among the 14 hip joints that underwent simple core decompression surgery， 7 femoral heads experienced another collapse with a 50%collapse rate， and 6 joints underwent total hip replacement with a 42.86% reoperation rate.Among the 18 hip joints undergoing core decompression and bone grafting surgery， 5 had femoral head collapse， with a collapse rate of 27.78%， and 3 joints underwent total hip replacement with a hip joint reoperation rate of 16.67%.9 patients who underwent unilateral core decompression combined with bone grafting surgery and did not undergo further surgery achieved good clinical efficacy after surgery.The Harris score and VAS score of those patients improved significantly after surgery （P＜0.01）.
Conclusion
Core decompression for necrosis of the femoral head has received attention from the academic community， and China has become a core force in this field with certain advantages.Bone grafting materials and regenerative cell therapy are current research hotspots that have attracted much attention from the academic community.Core decompression combined with bone grafting and cell therapy is an effective treatment for early and mid stage necrosis of the femoral head， which can improve hip preservation rate， delay or even avoid patients undergoing total hip replacement surgery.
Small cell osteosarcoma is a rare subtype of osteosarcoma with a poor prognosis.It is difficult to differentiate small cell osteosarcoma histopathologically from other malignant bone small cell tumors， especially Ewing’s sarcoma， due to their very similar immunohistochemical features.A diagnosis cannot be made by local puncture or biopsy when no tumor-affected bone is obtained， which affects the treatment plan.Therefore， it is of great significance to make a definite diagnosis of small cell osteosarcoma before surgery.This article briefly reviews the clinical， imaging， pathological， therapeutic， and prognostic features of small cell osteosarcoma.
Lung cancer is a malignancy with the highest incidence and mortality rates worldwide，and the early-stage imaging findings of lung cancer are often pulmonary nodules.Multiple pulmonary nodules have attracted great attention due to their increasing detection rate and high specificity.Thus，accurate prediction of the nature of pulmonary nodules is crucial for early diagnosis and treatment of lung cancer.In recent years， there have been great improvements in the diagnosis of pulmonary nodules due to the integration of artificial intelligence （AI） into medical technologies， particularly the application of deep learning， machine learning， and radiomics to analyze and predict the features and nature of pulmonary nodules.These approaches have dramatically enhanced the efficiency and accuracy of early screening for lung cancer， offering important guidance for the diagnosis and treatment of this malignancy.This article reviews the progress in AI application in the diagnosis of pulmonary nodules， especially in multiple pulmonary nodules， and analyzes the current advantages and limitations of AI technology as well as future development directions， aiming to provide new ideas and methods for the diagnosis and treatment of multiple pulmonary nodules.
