Nursing Practice for a Case of Acute Left Heart Failure Complicated with Colonic Impaction

Research Background: Heart failure is a type of organic heart disease caused by excessive ventricular load, leading to insufficient myocardial contractility and decreased cardiac output in the body. With the progression of the patient's condition, gastrointestinal dysfunction is frequently complicated. At the same time, the accumulation of feces in the body (colonic impaction) can also increase the burden on the patient’s heart, triggering or exacerbating the occurrence or progression of heart failure. Purpose: this article focuses on the correlation between colonic impaction and heart failure, using the nursing experience of a case of acute left heart failure complicated by colonic impaction as an example, in order to provide clinical evidence for the care of patients with colonic impaction combined with heart failure in the future. Method: By using innovative thinking, the stomach tube is used to replace the enema tube, which is inserted through the anus to reach the end of the colon. By combining acupressure at points such as Zhongwan, Tianzhu, and Guanyuan, it helps promote the elimination of fecal impaction. Conclusion: This case reflects the innovative thinking and adaptability of nurses, providing a new clinical approach for the aggravation of the condition of long-term heart failure patients due to constipation issues. Further research in clinical practice is warranted.

Nitrogen application and intercropping change microbial community diversity and physicochemical characteristics in mulberry and alfalfa rhizosphere soil

Intercropping of mulberry(Morus alba L.)and alfalfa(Medicago sativa L.)is a new forestry-grass compound model in China,which can provide high forage yields with high protein.Nitrogen application is one of the important factors determining the production and quality of this system.To elucidate the advantages of intercropping and nitrogen application,we analyzed the changes of physicochemical properties,enzyme activities,and microbial communities in the rhizosphere soil.We used principal components analysis(PCA)and redundancy discriminators analysis to clarify the relationships among treatments and between treatments and environmental factors,respectively.The results showed that nitrogen application significantly increased pH value,available nitrogen content,soil water content(SWC),and urea(URE)activity in rhizosphere soil of monoculture mulberry.In contrast,intercropping and intercropping+N significantly decreased pH and SWC in mulberry treatments.Nitrogen,intercropping and intercropping+N sharply reduced soil organic matter content and SWC in alfalfa treatments.Nitrogen,intercropping,and intercropping+N increased the values of McIntosh diversity(U),Simpson diversity(D),and Shannon-Weaver diversity(H’)in mulberry treatments.However,PC A scatter plots showed clustering of monoculture mulberry with nitrogen(MNE)and intercropping mulberry without nitrogen(M0).Intercropping reduced both H’and D but nitrogen application showed no effect on diversity of microbial communities in alfalfa.There were obvious differences in using the six types of carbon sources between mulberry and alfalfa treatments.Nitrogen and intercropping increased the numbers of sole carbon substrate in mulberry treatments where the relative use rate exceeded 4%.While the numbers declined in alfalfa with nitrogen and intercropping.RDA indicated that URE was positive when intercropping mulberry was treated with nitrogen,but was negative in monoculture alfalfa treated with nitrogen.Soil pH and SWC were positive with mulberry treatments but were negative with alfalfa treatments.Intercropping with alfalfa benefited mulberry in the absence of nitrogen application.Intercropping with alfalfa and nitrogen application could improve the microbial community function and diversity in rhizosphere soil of mulberry.The microbial community in rhizosphere soil of mulberry and alfalfa is strategically complementary in terms of using carbon sources.