Table of Content

10 September 2026, Volume 7 Issue 9 Previous Issue   

Research Paper

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Dynamic blood pressure changes and their association with postoperative complications after revascularization surgery for moyamoya disease GU Qiuping, ZHANG Weiwei, XU Gaowei, WANG Jingyi, TANG Xiaolan, YUAN Yuan 2026, 7 (9):  1029-1035.  doi: 10.3761/j.issn.2096-7446.2026.09.001 Abstract ( )   HTML ( )   PDF (1345KB) ( )   Save Objective To analyze the association of dynamic blood pressure changes and circadian rhythm characteristics within 72 hours after revascularization surgery with postoperative complications in patients with moyamoya disease，and to provide a basis for the precise management of postoperative blood pressure. Methods Clinical data of 401 patients with moyamoya disease who underwent revascularization surgery at a tertiary Grade A hospital in Zhejiang Province from January 2020 to January 2024 were retrospectively analyzed. The collected data included general patient information and hourly systolic and diastolic blood pressure measurements within 72 hours after surgery. Blood pressure parameters were calculated for three postoperative time intervals：0-24 h，25-48 h，and 49-72 h. Based on the change trend of the nocturnal blood pressure decline rate over three consecutive days，the circadian rhythm patterns of systolic blood pressure were classified into three levels：fluctuation，deterioration pattern，and persistent deterioration. Multivariable logistic regression was performed to examine the association between blood pressure variability indicators and postoperative complications within 7 days after surgery. Results The incidence of postoperative complications was 26.93%（108/401）. Multivariable logistic regression analysis showed that deterioration of systolic circadian rhythm（aOR=1.366，95%CI：1.025-1.821，P=0.033） and elevated mean systolic blood pressure within 0~48 hours after surgery（aOR=1.611，95%CI：1.245-2.085，P<0.001） were independent risk factors for postoperative complications. Each one-standard-deviation increase of 11.1 mmHg in mean systolic blood pressure（123.4 mmHg，1 mmHg=0.133 kPa） was associated with a 61.1% increase in the risk of complications. Conclusion The first 48 hours following revascularization surgery for moyamoya disease represent a pivotal time window. During this period，stringent blood pressure control should be exercised，and clinicians should be alert to potential dynamic deterioration of the circadian rhythm. Figures and Tables | References | Related Articles | Metrics

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A study on the identification of symptom clusters and warning symptoms in patients with acute decompensated chronic heart failure ZHAO Fei, CHEN Jieying, MAO Yue, YAO Meiqi, JIN Jingfen 2026, 7 (9):  1036-1043.  doi: 10.3761/j.issn.2096-7446.2026.09.002 Abstract ( )   HTML ( )   PDF (1196KB) ( )   Save Objective To identify the symptom clusters and warning symptoms in patients with acute decompensated heart failure（ADHF），and to analyze the correlation between the severity of warning symptoms and cardiac function and blood biochemical indexes. Methods From September 2023 to September 2024，268 ADHF patients hospitalized in the cardiology wards of a tertiary Grade A hospital in Hangzhou were selected by convenience sampling. The general information questionnaire and the revised Memory Symptom Assessment Scale were used to conduct a questionnaire survey，and the related indexes of cardiac function and blood biochemistry of patients were collected after admission. The symptom clusters were extracted by principal component analysis，and the warning symptoms of the symptom cluster were determined based on the results of the Apriori algorithm. Correlation analysis was used to explore the relationship between warning symptoms and cardiac function and blood biochemistry. Results There were four symptom clusters in ADHF patients，including the fluid retention symptom cluster，the respiratory fatigue symptom cluster，the emotional and psychological symptom cluster，and the digestive and metabolic symptom cluster. Each symptom cluster corresponds to a specific warning symptom：leg or arm edema，dyspnea when lying flat，a sense of sadness，and dry mouth. The serum type B natriuretic peptide（BNP） level was positively correlated with the severity of leg or arm edema（r=0.223，P=0.033）. The serum BNP level was positively correlated with the severity of dyspnea when lying flat（r=0.201，P=0.020）. The cardiac function classification was positively correlated with the severity of sadness（r=0.360，P=0.001） and dry mouth（r=0.238，P=0.004）. Serum potassium was negatively correlated with the severity of dyspnea when lying flat（r=-0.249，P=0.004），and left ventricular ejection fraction（LVEF） was negatively correlated with leg or arm edema（r=-0.171，P=0.018）. Conclusion Warning symptoms exist in four symptom clusters among ADHF patients. The severity of warning symptoms is related to cardiac function classification，LVEF，serum potassium and serum BNP. It serves as a precise foundation for clinical nursing personnel to detect early changes in patients’ clinical status and develop individualized symptom management strategies. Figures and Tables | References | Related Articles | Metrics

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Construction and validation of a risk prediction model for failure of radial artery catheterization in critically ill children YUAN Pengying, CHEN Jinlu, LUO Yi, FENG Lin, GAN Qilin, ZHONG Yongmei 2026, 7 (9):  1044-1051.  doi: 10.3761/j.issn.2096-7446.2026.09.003 Abstract ( )   HTML ( )   PDF (1217KB) ( )   Save Objective Construct and validate a risk prediction model for failure of radial artery catheterization in critically ill children. Methods A total of 405 children admitted to a Grade A tertiary specialized hospital in Guangdong Province from February 2023 to April 2024 were enrolled as the modeling cohort，and 111 children admitted from May to August 2024 were selected as the validation cohort. General data，clinical diagnosis and treatment information，laboratory test results，and catheterization records of the children were prospectively collected. Univariable analysis and logistic regression analysis were performed to construct a risk prediction model for radial artery catheterization failure in critically ill children. A nomogram was plotted and the model efficacy was evaluated. Results Among the 516 children in the group，287 cases experienced catheterization failure，with a total failure rate of 55.62%（287/516）.Logistic regression analysis identified body height（length）（OR=0.978），APACHE Ⅱ score（OR=1.095），operator’s catheterization experience（OR=0.737），sedation（OR=0.415），radial artery pulsation status（moderate pulse：OR=3.292，absent pulse：OR=7.984） and hemoglobin level（OR=0.492） as independent predictors of catheterization failure. The area under the receiver operating characteristic curve of the model in the modeling cohort and the validation cohort were 0.823 and 0.774，respectively. The Hosmer-Lemeshow test indicated good model calibration（modeling cohort：χ2=7.123，P=0.624；validation cohort：χ2=9.040，P=0.434）. The clinical decision curves demonstrated that the model had good clinical utility. Conclusion The risk prediction model established in this study exhibits good predictive performance，which facilitates early identification of children with difficult radial artery catheterization by nurses and provides a reference for formulating individualized catheterization protocols. Figures and Tables | References | Related Articles | Metrics

Special Planning-Intelligent Nursing Care for Emergency and Critical Illnesses

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Construction and application of information management platform for stroke dysphagia LIU Qiuhong, BAI Huihua, YU Yang, ZHEN Yushan, YIN Junlian, YANG Ting 2026, 7 (9):  1052-1059.  doi: 10.3761/j.issn.2096-7446.2026.09.004 Abstract ( )   HTML ( )   PDF (1361KB) ( )   Save Objective To construct an information management platform for stroke dysphagia and to explore its application effect. Methods Based on evidence combined with clinical practice，the information intelligent reminders of swallowing function screening，swallowing disorder assessment，and multidisciplinary collaborative intervention were set up，and structured nursing measures were pushed through the modified Gugging Swallowing Screen（GUSS），and a trinity of “screening-assessment-intervention” information management platform for stroke dysphagia was constructed. The missed rate，swallowing function improvement rate，average number of days of swallowing function improvement，nurse dysphagia management score，nurse satisfaction and nutritional indicators at discharge from October 2024 to February 2025 before the application of the stroke dysphagia information management platform and from March to July 2025 after application of the platform were compared in a tertiary A hospital in Changzhou. Results After applying the stroke dysphagia information management platform，the missed rate of swallowing disorder re-evaluation decreased from 36.4% to 0，with a statistically significant difference（P<0.001）.The average number of days of swallowing function improvement decreased from 9.00（7.25，11.00） days to 6.00（6.00，9.00） days，and the difference was statistically significant（P=0.002）. The improvement rate of swallowing function and nutritional indexes at discharge in the experimental group were higher than those in the control group. The management score of nurses and nurses’ satisfaction were higher than those of the control group，and the differences were statistically significant（all P<0.05）. Conclusion The information management platform for stroke dysphagia constructed in this study has shown good results in single-center application，which can standardize the management process，improve patient prognosis and enhance the professional ability of nurses. Figures and Tables | References | Related Articles | Metrics

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Study on the application of a secondary storage room information system in lean management of ICU disposable consumables SHEN Danping, GAO Xin, GAO Xin, WANG Lilu, DAI Keke 2026, 7 (9):  1060-1066.  doi: 10.3761/j.issn.2096-7446.2026.09.005 Abstract ( )   HTML ( )   PDF (1376KB) ( )   Save Objective To evaluate the effectiveness of integrating a secondary storage information system with the Lean 5S Management Model in managing disposable medical supplies in the Intensive Care Unit（ICU），to address issues commonly associated with traditional management approaches，such as blind spots in shelf-life monitoring，low inventory efficiency，billing errors，and excessive waste，thereby improving management accuracy and patient safety. Methods A combined model of the secondary storage information system and lean 5S management was implemented in the ICU. The secondary storage system was interfaced with the hospital’s Health Information System（HIS），enabling digital management of consumables including inbound and outbound tracking，inventory alerts，and expiration monitoring. Real-time updates and information sharing were ensured. Simultaneously，the lean 5S principles—Sort，Set in order，Shine，Standardize，and Sustain—were applied to optimize storage conditions and standardize supply usage processes. A non-concurrent controlled study was conducted in the intensive care unit （ICU） of a tertiary Grade A hospital. Eighty-four categories of low-value disposable medical supplies used between January 2024 and June 2025 served as the study material. The control phase（January-September 2024） adopted conventional manual management，whereas the intervention phase（October 2024-June 2025） implemented a secondary storage information system combined with Lean 5S management. Key indicators included time per inventory count，response time for supply requisitions，expiration rate，billing error rate，adverse event rate，per capita daily supply cost，and monthly inventory turnover rate. Results After implementing the integrated model，management efficiency improved significantly. The average time for a single inventory count decreased from（38.52±6.73）minutes to（12.18±3.25）minutes（P<0.001），and the supply requisition response time dropped from（4.21±1.05） hours to（1.05±0.33） hours（P<0.001）. Quality indicators also improved markedly，the expiration rate declined from 5.37% to 0.76%（P<0.01），the billing error rate from 3.12% to 0.53%（P<0.01），and the adverse event rate from 1.57% to 0.35%（P<0.001）. In terms of economic outcomes，the per capita daily supply cost was reduced from（18.75±3.62）CNY to（9.83±2.17） CNY（P<0.001），while the monthly inventory turnover rate increased from 62.1% to 89.6%. Conclusion The integration of the ICU secondary storage information system with the Lean 5S Management Model demonstrates significant effectiveness in managing disposable medical supplies. Through real-time digital tracking and meticulous on-site management，this model effectively addresses issues of expiration oversight，human error，and resource waste inherent in traditional approaches. It enhances operational efficiency，ensures supply safety，and enables refined cost control，offering a standardized and scalable solution for ICU supply management. Figures and Tables | References | Related Articles | Metrics

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Application of a mobile patient-physician interaction platform for perioperative inspiratory muscle training in patients undergoing heart valve replacement WANG Huizi, DING Lan, JI Feifei, WANG Mengtian, XIE Yihong 2026, 7 (9):  1067-1075.  doi: 10.3761/j.issn.2096-7446.2026.09.006 Abstract ( )   HTML ( )   PDF (1366KB) ( )   Save Objective To explore the efficacy of a mobile patient-physician interactive platform for perioperative inspiratory muscle training（IMT） in patients undergoing heart valve replacement. Methods Using the convenient sampling method，a total of 124 patients who underwent cardiac valve replacement in the cardiovascular surgery department of a tertiary grade A hospital in Zhejiang Province from August 2023 to June 2024 were selected by convenience sampling and randomly divided into an experimental group and a control group using a random number table. The experimental group received IMT combined with a mobile patient-physician interaction platform，while the control group received conventional respiratory function exercise. Cardiopulmonary function indicators，frailty levels，cardiopulmonary function and postoperative pulmonary complications were compared between the two groups at discharge and during the one-month follow-up outpatient visit. Results A total of 122 patients were collected in this study，and one dropout each in the experimental and control groups. Patients who received mobile platform-based IMT showed significantly better frailty levels，cardiopulmonary function，and postoperative pulmonary complications at the one-month follow-up compared to the control group（P<0.05）. Additionally，interaction effects were observed in frailty score，grip strength，Five-Times Sit-to-Stand Test（FTSTS） and pulmonary function indicators（P<0.05）. Conclusion IMT delivered via a mobile patient-physician interaction platform improves cardiopulmonary function，reverses frailty，and reduces postoperative pulmonary complication rates in patients following heart valve replacement，offering a novel practical pathway for continuity of care during home-based rehabilitation. Figures and Tables | References | Related Articles | Metrics

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Design and application of an intelligent demand Q&A program for emergency department based on humanistic care concept HUANG Shuixiu, LIANG Li, ZHANG Wei, ZHAO Yu 2026, 7 (9):  1076-1081.  doi: 10.3761/j.issn.2096-7446.2026.09.007 Abstract ( )   HTML ( )   PDF (1038KB) ( )   Save Objective To design an intelligent demand Q&A program based on the humanistic care concept for emergency care and verify its application effectiveness. Methods From January 2023 to December 2024，4，050 consultation records of patients and their families in the emergency department of a tertiary grade A hospital in Shenzhen were collected. Content analysis was used to classify the frequently asked questions，and an intelligent demand Q&A program integrating the humanistic care concept was designed. The program was officially launched and applied in the emergency department in January 2025. Using the continuous inclusion method，patients visiting the emergency department in January to June 2025 were the experimental group（n=300），and those in January to June 2024 were the control group（n=300）. The two groups maintained the same emergency service and nursing procedures except for the Q&A program. A self-designed questionnaire was used to evaluate patient satisfaction，and efficiency indicators such as nurse consultation load and response time were collected. Semi-structured interviews were conducted to understand the experience of patients in the experimental group after using the program. Results From January to June 2025，the program was used a total of 21，086 times，with an average of 117 uses per day. The average number of daily manual consultations per nurse in the experimental group（12.5 ± 3.2） was significantly lower than that in the control group（24.4±4.1），and the average response time for information retrieval in the expe-rimental group（1.5±0.5 min） was significantly shorter than that in the control group （3.2 ± 0.8 min）（P<0.001）. The experimental group scored significantly higher than the control group in all dimensions，including information accuracy，information accessibility，language affinity，and overall satisfaction（P<0.001）. The qualitative interview results identified two themes：the program’s functions were practical，effectively alleviating information anxiety；the language was warm and empathetic，enhancing the sense of security during medical treatment. Conclusion The emergency intelligent demand Q&A program designed under the humanistic care concept can effectively meet the dual needs of emergency patients for information and emotions，significantly improve their medical service experience and nursing work efficiency，providing a practical path for the integration development of intelligence and humanism in emergency care. Figures and Tables | References | Related Articles | Metrics

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Application of artificial intelligence in critical care：a scoping review YU Yanchao, GAO Xin, WENG Fengxia, WEI Jianhua, SANG Ming, ZHU Yongkang, CHEN Xiaoyan 2026, 7 (9):  1082-1088.  doi: 10.3761/j.issn.2096-7446.2026.09.008 Abstract ( )   HTML ( )   PDF (1148KB) ( )   Save Objective To systematically synthesize the current research status，application scenarios，technical challenges，and future development directions of artificial intelligence（AI） in the field of critical care. This review aims to provide novel research perspectives and theoretical foundations for the in-depth integration of AI and critical care，thereby promoting improvements in patient prognosis and healthcare quality. Methods Using the scoping review framework proposed by Arksey et al.，relevant literature was searched in databases such as PubMed，Web of Science，CNKI，and Wanfang Database，with the search period up to April 30，2025，and a total of 17 articles were ultimately included. Results The applications of AI in critical care primarily focus on five core domains，including monitoring and early warning systems，clinical decision support systems，documentation automation，resource allocation optimization，and predictive analysis models. The primary challenges include data fragmentation in AI models，limited generalization capability，the need to improve medical staff’s acceptance and practical skills with AI tools，as well as ethical and privacy concerns. Conclusion The integration of AI into critical care can significantly optimize workflow efficiency and enhance work performance. Future research should prioritize the establishment of multi-center data sharing platforms，the refinement of interdisciplinary collaboration mechanisms，and the design of patient-centered AI systems，to fully unleash the value of AI in improving the quality and efficiency of critical care services. Figures and Tables | References | Related Articles | Metrics

Guideline and Standard

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Interpretation of Guidelines for the Management of Acute Behavioural Disturbance in the Emergency Department（3rd Edition） CAO Yulong, GAO Yan, GAN Xiuni 2026, 7 (9):  1089-1095.  doi: 10.3761/j.issn.2096-7446.2026.09.009 Abstract ( )   HTML ( )   PDF (1323KB) ( )   Save In May 2025，the Royal College of Emergency Medicine（RCEM） released the Guideline for the Management of Acute Behavioural Disturbance in the Emergency Department（Third Edition），representing the latest evidence-based practice guidance on the management of acute behavioural disturbance（ABD） in the international emergency medicine field. The guideline characterizes ABD as a state of acute psychomotor agitation accompanied by abnormal physiological changes. It covers key aspects including the identification and definition of ABD，safety risk assessment，verbal and environmental de-escalation，selection of sedative agents，resuscitation and monitoring，principles of physical restraint，and management considerations for special populations. This article provides an interpretation of the revision background，core recommendations，and pharmacological options of the guideline，and discusses its applicability within the Chinese clinical environment，aiming to provide a reference for the standardized and safe management of patients with ABD in emergency departments in China. Figures and Tables | References | Related Articles | Metrics

Emergency Care Research

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A qualitative study on the symptom experience and multi-dimensional coping strategies of adult patients with myocarditis ZHONG Chenchen, ZHANG Liping, WEN Jiaqi, YE Yan, LIU Yu 2026, 7 (9):  1096-1100.  doi: 10.3761/j.issn.2096-7446.2026.09.010 Abstract ( )   HTML ( )   PDF (893KB) ( )   Save Objective To explore symptom experiences and coping strategies in adult myocarditis patients using the Symptom Experience Model（SEM），addressing a domestic research gap and informing personalized nursing. Methods A descriptive qualitative research method was employed，involving purposeful sampling to select 15 myocarditis patients admitted to a tertiary Grade A hospital in Wuhan from January to April 2025 for semi-structured interviews. The interview outline was designed based on the SEM，and the data were analyzed using directed content analysis. Results Three main themes and nine sub-themes were summarized.①Symptom attribution：lack of initial knowledge，rapid progression，tortuous medical seeking.②Symptom perception：significant somatic symptoms（cold-like，chest symptoms with doom，systemic disturbances）；negative emotions（psychological fortuitism，anxiety and fear，stress disorders）；social identity disconnection（interrupted roles，suspended values）.③Symptom coping：passive regulation，seeking balance，post-traumatic growth. Conclusion The symptom experience of adult myocarditis patients is complex and insidious. In the future，it is necessary to develop personalized plans that integrate physiological rehabilitation，emotional support，and social function recovery to optimize patient care outcomes. Figures and Tables | References | Related Articles | Metrics

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Multidisciplinary collaborative nursing for a severely obese patient with multiple traumatic fractures due to traffic injuries and menstrual bleeding LI Yuanyuan, FAN Xiaodan, PENG Donglai, ZHU Xiaoli, FAN Zhengxia, MO Yanlan, DING Yun 2026, 7 (9):  1101-1103.  doi: 10.3761/j.issn.2096-7446.2026.09.011 Abstract ( )   HTML ( )   PDF (542KB) ( )   Save This paper summarized the multidisciplinary collaborative nursing experience of multiple traumatic fractures resulting from a traffic accident in a severely obese patient，complicated by menstrual bleeding. Addressing issues such as the communication barriers posed by minority languages，which hinder decision-making participation，the anticoagulation dilemma triggered by “trauma + menstrual bleeding”，the challenges faced in skin management due to the combination of pain and obesity，and the differences in demand between ethnic customs and nutritional value，the key nursing interventions were implemented，including bilingual communication in Uyghur and Chinese to assist the patient in participating in treatment decision-making，multidisciplinary collaboration to combine traditional Chinese and Western medicine concepts to prevent thrombosis，improving decompression methods to prevent pressure-related injuries，balancing ethnic dietary customs with nutritional requirements through scientific intake. Following 30 days of individualized care，the patient showed significant improvement and was discharged. References | Related Articles | Metrics

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Nursing care for a patient with Marfan syndrome complicated by malignant arrhythmia undergoing extravascular implantable cardioversion defibrillator therapy HUANG Dandan, ZHU Shuting, CHEN Xi, SONG Jianping 2026, 7 (9):  1104-1107.  doi: 10.3761/j.issn.2096-7446.2026.09.012 Abstract ( )   HTML ( )   PDF (731KB) ( )   Save To summarizes the perioperative nursing experience of a patient with Marfan syndrome complicated with malignant arrhythmia undergoing implantation of an extravascular implantable cardioverter defibrillator（EV-ICD）. Key nursing points included malignant arrhythmia risk management and preoperative education，integrated symptom-monitoring-device event surveillance，prevention and management of postoperative complications，comprehensive perioperative rehabilitation，targeted psychological interventions，and promotion of proactive health behaviors. Following multidisciplinary treatment and comprehensive nursing care，the patient recovered well and was discharged after a 31-day hospital stay. At the 1-month follow-up，no recurrence of malignant arrhythmias or device-related complications was observed，and the patient’s level of proactive health behaviors had promoted significantly. References | Related Articles | Metrics

Critical Care Research

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Family support service practice for a neonate with giant omphalocele complicated by pulmonary hypertension during conservative treatment YU Jun, LI Jianping, WU Xiaohua, CHENG Xiaoying 2026, 7 (9):  1108-1111.  doi: 10.3761/j.issn.2096-7446.2026.09.013 Abstract ( )   HTML ( )   PDF (721KB) ( )   Save We summarized nursing experience of family support service for a neonate with giant omphalocele complicated by pulmonary hypertension undergoing conservative treatment，which was characterized by long-term care，high home-care difficulty，and prominent family psychological issues. Key nursing points were as follows. Based on family needs assessment，the certified child life specialists（CCLS） led multidisciplinary team implemented syste-matic interventions including parent-child companionship，sibling support，and picture book healing. After 33 days of family-integrated care，parental self-efficacy improved，anxiety decreased. The dressing changes，nasogastric feeding and oxygen therapy were independently performed，leading to successful discharge. Follow-up showed good healing of the omphalocele sac with no complications，reduced anxiety behavior among family members，and return to daily life. References | Related Articles | Metrics

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Nursing care of a patient with medullary infarction complicated by Mallory-Weiss tear following vertebral artery stenting DING Yang, ZHUANG Yiyu, HUANG Ruiying, YE Shan 2026, 7 (9):  1112-1114.  doi: 10.3761/j.issn.2096-7446.2026.09.014 Abstract ( )   HTML ( )   PDF (759KB) ( )   Save To summarize the nursing experience of a patient who developed medullary infarction accompanied by Mallory-Weiss tear after vertebral artery stenting. Faced with the core challenge of balancing the risk of neurological deterioration from medullary infarction against the threat of fatal bleeding from the mucosal tear under antithrombotic therapy，nursing interventions were implemented，including systematic neurological monitoring for early warning of medullary infarction，integrated management of the Mallory-Weiss tear combining Chinese and Western medicine for antiemesis，stepwise and dynamically-balanced resumption of antithrombotic therapy，and risk-orientated phased nutritional support and swallowing management. After 16 days of treatment and nursing care，the patient was successfully discharged with good recovery during follow-up. References | Related Articles | Metrics

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Nursing care of staged treatment for a premature infant with gastrointestinal malformation and congenital laryngomalacia undergoing tracheotomy SHI Fengshuang, CHEN Lili, LI Liuqing, WEI Mengdi, ZHU Jihua 2026, 7 (9):  1115-1118.  doi: 10.3761/j.issn.2096-7446.2026.09.015 Abstract ( )   HTML ( )   PDF (1058KB) ( )   Save To summarize the nursing experience of a premature infant with gastrointestinal malformation and congenital laryngomalacia who underwent tracheotomy and staged surgeries. In response to key nursing challenges including prematurity and low birth weight，staged surgeries and tracheotomy，an evidence-based perioperative comprehensive management strategy was implemented，including preoperative prevention of aspiration，postoperative refined airway management and tracheotomy care，precise nursing care for gastrointestinal function reconstruction after duodenal anastomosis and gastrostom，optimization of nursing cooperation during internal traction elongation and risk prevention of the supporting gastric tube，sequential nutritional support and dynamic feeding management. After 147 days of meticulous treatment and nursing，the infant’s gastrointestinal function recovered well，and the patient was transferred to the rehabilitation department in stable condition. Figures and Tables | References | Related Articles | Metrics

Career Development of Nurses

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Application of high-stress scenario-based escape room training in competency development of emergency extracorporeal membrane oxygenation nursing teams ZHANG Rui, WANG Sa, DING Youya, XU Shurong, WANG Yuwei 2026, 7 (9):  1119-1124.  doi: 10.3761/j.issn.2096-7446.2026.09.016 Abstract ( )   HTML ( )   PDF (899KB) ( )   Save Objective To explore the application effect of high-stress scenario-based escape room training on the core competency improvement of emergency extracorporeal membrane oxygenation（ECMO） nursing teams. Methods From March to June 2025，convenience sampling was used to recruit 64 nurses involved in ECMO resuscitation in the emergency department of a tertiary grade-A hospital in Hangzhou. They were randomly divided into an experimental group（n=32） and a control group（n=32） using a random number table. The experimental group received escape room scenario training built on real emergency ECMO procedures in addition to routine training，while the control group received conventional ECMO team training. The training effect was evaluated through theoretical knowledge tests，skill operation assessments，the Teamwork Ability Questionnaire，and the Critical Thinking Disposition Inventory. Results After the training，the experimental group scored significantly higher than the control group in ECMO theoretical knowledge and skill operation（P<0.05）. The experimental group also demonstrated significantly better scores in all dimensions of teamwork ability and critical thinking ability compared to the control group（P<0.05）. Conclusion Escape room scenario training designed based on the high-stress，time-sensitive features of emergency ECMO can enhance the comprehensive competence of nursing teams in complex resuscitation environments. It shows particular advantages in cultivating non-technical skills such as teamwork and critical thinking，and may provide a new practical pathway for the training of critical care nursing teams. Figures and Tables | References | Related Articles | Metrics

Evidence Synthesis Research

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Meta integration of caring touch cognition and experience among adult intensive care unit medical staff and patients SHAO Hong, CHENG Yifeng, LI Ji, ZHOU Xiliang, ZHANG Chao, JIANG Junmeng, HUANG Jinxiu 2026, 7 (9):  1125-1131.  doi: 10.3761/j.issn.2096-7446.2026.09.017 Abstract ( )   HTML ( )   PDF (1074KB) ( )   Save Objective To systematically integrate the qualitative research on the caring touch cognition and experience of medical staff and patients in adult intensive care units. Methods We searched qualitative studies on adult ICU caring touch experience in databases such as PubMed，Web of Science，CNKI，and Wanfang Database，with a search period from the establishment of the database to September 1，2025. Two researchers independently conducted article screening and data extraction. The qualitative research quality evaluation tool（2016 edition） of the Evidence Based Healthcare Center of the Joanna Briggs Institute in Australia was used for literature quality evaluation，and the results were integrated using meta integration method. Results A total of 8 articles were included，and 43 research results were extracted. Similar results were classified into 11 new categories and integrated into 3 integrated results：benefits of caring touch for ICU nurse-patient relationships and communication，multidimensional psychological support provided by caring touch for patients，and the influencing factors of caring touch implementation. Conclusion Caring touch in adult ICU is an important way to maintain humanized communication and trust，providing multidimensional psychological support，and its implementation is influenced by multiple factors. Nursing managers should strengthen relevant training，optimize organizational environment and support systems，and improve the quality of ICU nursing. Figures and Tables | References | Related Articles | Metrics

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Systematic review of aspiration risk prediction models for stroke patients LI Xiangru, ZHOU Hong, GENG Jing, MAO Fangju, ZHOU Juan, XU Chenyang, LIU Qiang 2026, 7 (9):  1132-1139.  doi: 10.3761/j.issn.2096-7446.2026.09.018 Abstract ( )   HTML ( )   PDF (1364KB) ( )   Save Objective To systematically evaluate aspiration risk prediction models for stroke patients and provide evidence-based support for the early identification of high-risk patients in clinical practice. Methods A comprehensive search was conducted in multiple databases，including Wan fang，VIP，CNKI，China Biomedical Literature Database，Web of Science，PubMed，and Embase，with a search period from database inception to January 20，2025. Literature screening and data extraction were independently performed by two researchers，and the Prediction Model Risk of Bias Assessment Tool（PROBAST） was used for quality assessment. Results A total of 18 studies was included，encompassing 25 prediction models. The area under the receiver operating characteristic curve ranged from 0.715 to 0.955. Sixteen studies demonstrated good applicability，while two studies had poor applicability. All 18 studies exhibited a high risk of bias，mainly due to inappropriate data source selection，small sample size，insufficient handling of missing data，unreasonable variable selection，and a lack of model efficacy validation. Conclusion The existing stroke aspiration risk prediction models show good clinical applicability but are associated with a high risk of bias. Future research should focus on optimizing study design，enhancing external validation，and further assessing their clinical application value. Figures and Tables | References | Supplementary Material | Related Articles | Metrics

Review

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Difficult airway related risk assessment tools in ICU patients：a scoping review ZHANG Yuping, TANG Jiaying, WANG Dongxue, JI Jianguang, SHI Qingyu 2026, 7 (9):  1140-1149.  doi: 10.3761/j.issn.2096-7446.2026.09.019 Abstract ( )   HTML ( )   PDF (1332KB) ( )   Save Objective To conduct a scoping review on difficult airway related risk assessment tools for ICU adult patients，systematically categorize their types，current applications，and characteristics，and provide references for clinical risk identification and management. Methods A scoping review method was employed，with searches conducted in PubMed，Web of Science，CINAHL，Cochrane Library，CNKI，and Wanfang databases from inception to April 20th，2026. Two researchers independently performed literature screening and data extraction，followed by integrated analysis of the included studies. Results A total of 18 articles were included. Current risk assessment tools primarily included scale-based scoring or grading tools，structured clinical evaluations，and imaging devices or bedside tests. Different tools varied in terms of assessment objectives，implementation timing，cutoff value，and predictive efficacy. Conclusion There are various risk assessment tools for difficult airways in ICU patients，which are mainly applied to pre-intubation，peri-intubation，and extubation risk assessment. Clinically，the appropriate tool should be selected for phased，dynamic assessment based on the patient’s primary risks，the timing of evaluation，and bedside conditions. Figures and Tables | References | Related Articles | Metrics

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Nursing cooperation in PICC catheterization for patients with bilateral internal jugular vein thrombosis using magnetic navigation combined with intracardiac electrocardiogram technology XU Zhe, YU Chao, WU Xiaoli 2026, 7 (9):  1150-1152.  doi: 10.3761/j.issn.2096-7446.2026.09.020 Abstract ( )   HTML ( )   PDF (533KB) ( )   Save For a patient with bilateral internal jugular vein thrombosis，magnetic navigation combined with intracavitary electrocardiography technology was used for real-time positioning，coupled with posture and respiratory management，as well as dynamic catheter adjustment，to precisely control the catheter trajectory. Additionally，a modified calibration method for secondary catheterization was improved，PICC was successfully inserted. The catheter tip was accurately placed in the distal third of the superior vena cava.The catheter was maintained for 6 months and removed after treatment without thrombosis aggravation，detachment，malposition or other complications. References | Related Articles | Metrics