Liaocheng People's Hospital

ABSTRACTMitral valve papillary muscle rupture represents a rare yet critical complication of acute myocardial infarction, often leading to severe mitral regurgitation and subsequent pulmonary edema with high mortality. Despite optimal ventilatory support and pharmacological management, patients often exhibit refractory hypoxemia, rendering surgical intervention both technically demanding and high‐risk. A 40‐year‐old Asian male presented to the emergency department of Liaocheng People's Hospital following percutaneous coronary intervention (PCI) for acute myocardial infarction at an outside facility. Shortly post‐procedure, the patient developed dyspnea and oliguria. Despite endotracheal intubation, mechanical ventilation, and medical therapy, his condition deteriorated, necessitating transfer. Echocardiography and transesophageal echocardiography confirmed mitral valve papillary muscle rupture with severe regurgitation, complicated by profound pulmonary edema and refractory hypoxemia. Venovenous extracorporeal membrane oxygenation (VV‐ECMO) was promptly initiated, resulting in gradual improvement in oxygenation. Following a multidisciplinary evaluation, edge‐to‐edge mitral valve repair was successfully performed under VV‐ECMO support. ECMO was discontinued on postoperative day 4, and the patient was discharged after 14 days with marked clinical improvement. In cases of severe pulmonary edema secondary to mitral valve papillary muscle rupture post‐PCI for acute myocardial infarction, early VV‐ECMO implementation combined with edge‐to‐edge mitral valve repair under ECMO support may mitigate surgical risk and enhance outcomes. This integrated approach presents a viable therapeutic alternative for such high‐risk patients.

This report details a rare case of a frontal-ethmoid sinus mucocele with concurrent invasion of both anterior cranial fossa and orbital wall, manifesting primarily with ophthalmologic symptoms. A 64-year-old woman presented with right periorbital swelling accompanied with mild pain, photophobia, and epiphora. Endoscopic sinus surgery revealed extensive destruction of the skull base bone. Intraoperative findings included an intact dura mater without cerebrospinal fluid leakage. Histopathology identified a benign mucocele lined by respiratory epithelium. This case represents an exceptional presentation of a sinus mucocele with dual erosion into both anterior cranial fossa and orbital cavity. Endoscopic management achieved complete resolution without intracranial complications. This entity warrants consideration in patients with orbital symptoms and underlying sinus disease.

Patient safety competency (PSC) is a core element of nursing practice, essential for ensuring high-quality and safe patient care. Newly recruited nurses often face challenges such as transition shock, limited clinical experience, and fragmented safety education, which may hinder their ability to maintain patient safety. Most studies have assessed PSC using total scale scores, overlooking internal heterogeneity within this group. This study aimed to identify latent profiles of PSC among newly recruited nurses and explore the influencing factors to provide evidence for targeted competency development and management strategies. From July to August 2023, a convenience sample of newly recruited nurses was obtained from seven tertiary grade-A hospitals in Shandong Province, China. Data were collected using the General Information Questionnaire, the Transition Shock Scale of Newly Graduated Nurses, the Nurses' Perception of Organizational Support Scale, and the Patient Safety Nurse Competency Evaluation Scale. Latent Profile Analysis (LPA) was conducted to identify the potential subgroups of patient safety competency among newly recruited nurses. Univariate analysis and multivariate logistic regression were performed to examine the influencing factors associated with different latent profile categories. The patient safety competency of newly recruited nurses was categorized into 3 potential profiles: "high safety competency group" (36.9%), "medium safety competency group" (49.4%), and "low safety competency group" (13.7%). The results of the logistic regression analysis revealed that education level, average number of night shifts per week, participation in safety training, involvement in patient safety-related projects, transition shock, and perceived organizational support were significant predictors of patient safety competency among newly recruited nurses (P < 0.05). This study identified three distinct latent profiles of patient safety competency among newly recruited nurses, revealing a moderate overall competency level with notable heterogeneity. Nursing managers should pay particular attention to nurses with moderate and low competency levels and implement targeted, evidence-based interventions to strengthen their patient safety competency and promote safer clinical practice. Not applicable.

BackgroundChronic sinusitis is a common condition that can greatly affect patients’ quality of life. It is essential to understand patients’ knowledge, attitudes, and practices (KAP) regarding chronic sinusitis and its surgical treatment to enhance patient outcomes and optimize clinical management. This study aimed to investigate KAP among chronic sinusitis patients to identify areas for targeted intervention and improvement.MethodsA cross-sectional study was conducted with chronic sinusitis patients at the Ear, Nose, and Throat Department of Liaocheng People’s Hospital from June 2019 to June 2022. Demographic data and KAP were collected using self-designed questionnaires.ResultsA total of 567 valid questionnaires were included, yielding a validity rate of 99.3%. Among the respondents, 314 were male (55.38%), and 260 individuals (45.86%) lived in urban areas. The mean scores for KAP were 7.86 ± 2.39 (possible range: 0–12), 17.69 ± 1.94 (possible range: 8–40), and 7.86 ± 2.39 (possible range: 7–35), respectively. Structural equation modeling demonstrated a direct impact of knowledge on attitude (β = −0.500, p < 0.001) and practice (β = 0.261, p = 0.001), and a direct impact of attitude on practice (β = 1.737, p < 0.001).ConclusionPatients with chronic sinusitis demonstrated insufficient knowledge and negative attitudes and practices towards both the condition and its surgical treatment. These findings highlight the need for targeted interventions to improve patient education and awareness. By addressing knowledge gaps and fostering positive attitudes towards treatment options, healthcare providers can empower patients to make informed decisions and enhance their management of chronic sinusitis.

BackgroundLiver transplantation (LT) involves substantial intraoperative blood loss and postoperative complications, yet the relationship between these factors remains incompletely defined. This study aimed to evaluate the impact of excessive intraoperative blood loss (EIBL) on postoperative complication rates.Material/MethodsWe enrolled adult patients who underwent liver transplantation at 5 centers from January 2015 to June 2024. Patients were categorized into EIBL (blood loss ≥1000 mL) and non-EIBL groups. Univariate and multivariate logistic regression analyses were performed to identify EIBL risk factors and to assess its effect on postoperative complications, with adjustment for confounders such as age, sex, and comorbidities. Risk factors for specific complications were also examined.ResultsIn total, 822 patients were included. Univariate and multivariate logistic regression analyses indicated that benign disease, previous major abdominal surgery, pre-LT intensive care unit stay, and preoperative albumin below 38 g/L were independent risk factors for EIBL. EIBL was significantly associated with postoperative biliary complications and severe complications (Clavien-Dindo grade ≥3). Further regression confirmed EIBL as an independent risk factor for biliary complications (P=0.034) and Clavien-Dindo grade 3 or higher complications (P=0.042). Kaplan-Meier analysis showed that the 5-year survival rate was significantly lower in the EIBL group than in the non-EIBL group (P=0.010).ConclusionsComprehensive preoperative assessment and meticulous surgical practice can reduce EIBL risk, thereby decreasing postoperative complications after LT and improving long-term survival.

Abstract Introduction The red blood cell distribution width-to-albumin ratio (RAR) is a composite biomarker reflecting integrated inflammation and nutrition status. Unlike conventional biomarkers assessing isolated pathways, RAR holistically evaluates their interplay, suggesting potential utility for cancer risk stratification. This study seeks to investigate the association between RAR and cancer in U.S. adults. Methods Using data from 43,094 NHANES participants (1999–2018), we employed multivariable logistic regression to assess RAR-cancer associations. Restricted cubic spline (RCS) evaluated nonlinear association and threshold effects. The study also used subgroup analysis and interaction tests to explore whether the association was stable in the population. Results In the cross-sectional study, 3,893 participants (9.0%) had cancer. RAR was positively associated with cancer among 43,094 participants aged ≥ 20 years. In the fully adjusted model, each per unit increase in RAR was associated with a 30% increase in the likelihood of cancer (OR = 1.30, 95% CI: 1.20 ~ 1.39, P &lt; 0.001). Participants in the top quartile of RAR had a 36% increased risk of cancer than those in the bottom quartile of RAR (OR = 1.36, 95% CI = 1.22 ~ 1.53, P &lt; 0.001). RCS revealed that the association between RAR and cancer was nonlinear (P for nonlinear = 0.028). Subgroup analyses showed that the association between RAR and cancer was significantly stronger in males group (P for interaction &lt; 0.001). Discussion This study demonstrates that a significant correlation was identified between RAR and risk of cancer in U.S. adults, suggesting that RAR may function as a clinically relevant biomarker for risk stratification and provides potential evidence for subsequent pathological mechanism research. Further large-scale prospective studies are warranted to delineate the role of RAR in cancer.