Background: Cognitive decline (CD) occurs frequently in elderly patients with cerebral small vessel disease (CSVD). In China, elderly patients are more likely to enter healthcare in community hospitals where no magnetic resonance imaging (MRI) is available. This study aimed to explore the screening value of Sylvian fissure ratio (SFR) on CD and compare its gender difference from community-transferred patients.Methods: We performed a single-center, observational study (collected between April 1, 2016, and March 1, 2019) to evaluate the association between Montreal Cognitive Assessment (MoCA) and SFR in 203 eligible community-transferred patients. Baseline characteristics of patients were collected during hospitalization. Multiple linear regression analyses were used to estimate the effect of variables on MoCA, and interactions between select variables were analyzed in different models. Receiver operating characteristic (ROC) curve analysis was used to evaluate the discriminative effect of SFR to severe CD.Results: We identified that a meaningful SFR cutoff of 0.05 had important screening value (likelihood ratio test, p = 0.067) on CD. The ratio had a lower screen value in males when compared to females (adjusted β, −5.54; 95% CI, −8.78 to −2.30 vs. adjusted β, −1.01; 95% CI, −2.84 to 0.82). The gender difference was further verified by ROC curve analysis, in which this discriminative effect was more potent in females (from 0.878 to 0.948) compared to males (from 0.838 to 0.837).Conclusion: An SFR of 0.05 may be more useful to distinguish CD in female patients with CSVD than male patients in whom the syndrome is suspected clinically.

Purpose. The aim of this study was to assess the effectiveness of multidisciplinary nursing based on fever, blood sugar, and swallowing function management in patients with acute stroke (AS). Methods. A total of 200 AS patients who were treated in our hospital from January 2016 to January 2020 were recruited and randomized at a ratio of 1 : 1 into a control group and a study group. The control group received standardized early rehabilitation nursing, and the study group received multidisciplinary nursing based on fever, blood sugar, and swallowing function management plus standardized early rehabilitation nursing. The patients were also assigned different blood glucose levels upon admission to a high blood glucose group or a normal blood glucose group. The clinical endpoint is clinical efficacy. Results. Multidisciplinary nursing resulted in better clinical outcomes and treatment efficiency in the patients in the study group versus standardized early rehabilitation nursing. When compared with the control group, the patients in the study group showed lower National Institute of Health Stroke Scale (NIHSS) scores, higher Barthel Index (BI) scores, lower fasting blood glucose levels and body temperature 24 hours after admission, a lower incidence of swallowing dysfunction and aspiration pneumonia 30 days after nursing, and lower C-reactive Protein (CRP) levels 7 days after nursing. The NIHSS scores of the high blood glucose group were significantly higher than those of the normal blood glucose group. Conclusion. Multidisciplinary nursing based on fever, blood sugar, and swallowing function management for patients with AS improves the clinical outcome and treatment efficiency, restores the swallowing function and blood glucose level, and ameliorates the long-term prognosis of patients.

Objective. To investigate the use of an integrated emergency nursing model with a multidisciplinary team (MDT) teaching method for practice of nursing towards multiple trauma in the emergency department and its influence on patients’ stress response and nursing satisfaction. Methods. The research subjects were 120 multiple trauma patients hospitalized to our hospital’s emergency department between January 2019 and January 2020, who were evenly divided into groups A ( n = 60 ) and B ( n = 60 ) based on the sequence of admission. For patients in group A, on the basis of whole optimization of the emergency nursing model, the MDT teaching and training were given to the nursing staff in group A. Patients in group B had their emergency nursing model completely optimized. The assessment scores of nursing staff were compared. The patients’ C-reactive protein (CRP) levels in peripheral circulation, first-aid time indices, treatment effect, risk of complications & nursing contentment were all investigated. Results. Nursing personnel in group A had considerably higher achievement scores than staff nurses in group B ( P < 0.001 ). CRP levels in group A were considerably lower following therapy ( P < 0.05 ) than those in group B. The time it took for group A to receive first assistance was considerably less than that for group B ( P < 0.001 ). Group A had a considerably superior treatment effect than group B ( P < 0.05 ). Complications occurred at a lower rate in group A ( P < 0.05 ) than in group B. Group A nurses were more satisfied than group B nurses ( P < 0.05 ). Conclusion. The entire optimization of the emergency nursing model combined with the MDT way of teaching can abbreviate the rescue process, reduce stress, improve treatment effect & reduce the possibility of complications in multiple trauma patients in the emergency department, and patients seem to be more comfortable with this nursing model. As a result, it should become more well known.