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In recent years, the perioperative surgical home model has been gradually applied to the posterior spinal fusion for adolescent idiopathic scoliosis. This review summarizes the application of perioperative surgical home model in adolescent idiopathic scoliosis surgery, including the concept, connotation and elements, hoping to provide reference and reference for complex and high-risk surgical procedures.
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Objective:To compare oxytocin combined with ergometrine with oxytocin alone in terms of primary prophylaxis for postpartum hemorrhage (PPH) at the time of cesarean section (CS).Methods:This was a multicenter double-blind randomized controlled interventional study comparing ergometrine combined with oxytocin and oxytocin alone administered at CS. From December 2018 to November 2019, a total of 298 parturients were enrolled in 16 hospitals nationwide. They were randomly divided into experimental group (ergometrine intra-myometrial injection following oxytocin intravenously; 148 cases) and control group (oxytocin intra-myometrial injection following oxytocin intravenously; 150 cases) according to 1∶1 random allocation. The following indexes were compared between the two groups: (1) main index: blood loss 2 hours (h) after delivery; (2) secondary indicators: postpartum blood loss at 6 h and 24 h, placental retention time, incidence of PPH, the proportion of additional use of uterine contraction drugs, hemostatic drugs or other hemostatic measures at 2 h and 24 h after delivery, the proportion requiring blood transfusion, and the proportion of prolonged hospital stay due to poor uterine involution; (3) safety indicators: nausea, vomiting, dizziness and other adverse reactions, and blood pressure at each time point of administration.Results:(1) The blood loss at 2 h after delivery in the experimental group [(402±18) ml] was less than that in the control group [(505±18) ml], and the difference was statistically significant ( P<0.05). (2) The blood loss at 6 h and 24 h after delivery in the experimental group were less than those in the control group, and the differences were statistically significant (all P<0.05). There were no significant differences between the two groups in the incidence of PPH, the proportion of additional use of uterine contraction drugs, hemostatic drugs or other hemostatic measures at 2 h and 24 h after delivery, the proportion requiring blood transfusion, and the proportion of prolonged hospital stay due to poor uterine involution (all P>0.05). (3) Adverse reactions occurred in 2 cases (1.4%, 2/148) in the experimental group and 1 case (0.7%, 1/150) in the control group. There was no significant difference between the two groups ( P>0.05). The systolic blood pressure within 2.0 h and diastolic blood pressure within 1.5 h of drug administration in the experimental group were higher than those in the control group, and the differences were statistically significant ( P<0.05), but the blood pressure of the two groups were in the normal range. Conclusion:The use of ergometrine injection in CS could reduce the amount of PPH, which is safe and feasible.
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Objective To explore the prevalence and the relative factors of the overweight and the obese in a population of Gansu Province pre-pregnancy women.and the effects of pre-pregnancy maternal body mass index (BMI) on gestational weight gain and pregnant outcome.Methods We conducted a populationbased birth cohort study in Gansu Province Maternity and Child Health Care Hospital from February,2010 to December,2011.Single live term birth women who have complete anthropometry were enrolled this study.They were categorized into four BMI groups according to World Health Organization's BMI recommendations for Asian populations.We explored the prevalence and the relative factors of the overweight and the obese,and the effects of pre-pregnancy maternal body mass index on gestational weight gain and birth outcomes by Chi-square test,analysis of variance.Results A total of 6 400 cases included in this study.The BMI range is from 13.3 to 38.1,the average BMI is (20.6 ±2.7).Among 6 400 cases,636 cases(9.9％) and 416 cases (6.5％) were overweight and obese.The average age (unit:years) is increase gradually in low weight group (27.8±3.8),normal group (29.1 ±4.3),overweight group (30.3 ±4.7) and obese group (30.6±4.6),the difference was statistically significant (F=77.490,P＜0.01).The result prompt that the median BMI increased with the increasing of maternal age (r=0.18,P＜0.01).The BMI of multiparous women (21.22 ±2.63) is higher than nulliparous women (20.43 ± 2.64),the difference was statistically significant (t=-9.630,P＜0.01).The BMI has negatively correlated with education level and economic income level (r=-0.06,P＜0.01; r=-0.04,P=0.036).With the increase of BMI,the weight gain of early (13 weeks) pregnancy (F=8.892,P＜ 0.01) and the total weight gain during whole pregnancy (F=21.700,P＜ 0.01) gradually reduced in four groups.The neonatal birth weight in overweight group is largest,in turn higher than obesity group,normal group and low weight group,the difference was statistically significant (F=11.261,P＜0.01).With increasing BMI,the incidence of pre eclampsia (x2=85.758,P＜0.05),gestational diabetes mellitus (x2=58.913,P＜0.05),postpartum hemorrhage (x2=13.501,P＜0.05),neonatal hypoglycemia (x2=6.563,P＜0.05) and neonatal pulmonary hyaline membrane (x2=9.579,P＜0.05) was increased.The incidence of caesarean section (x2=125.442,P＜0.05),macrosomia (x2=62.963,P＜0.05) and birth defects (x2=9.087,P＜0.05) also increased.The incidence of abnormal umbilical cord in overweight group is highest,in turn higher than normal group,low weight group,and the obesity group (x2=15.82g,P=0.001).The incidence of neonatal electrolyte disorder in obesity group was higher than low weight group,normal group,and the overweight group (x2=12.092,P=0.007).The incidence of preterm birth in overweight group is highest,in turn higher than obesity group,normal group and the low weight group (x2=7.865,P=0.049).Compared with the normal group,the risk of caesarean section (OR=l.700,95％ CI:1.325-2.181),pre-eclampsia (OR=2.436,95％ CI:1.578-3.761),gestational diabetes (OR=3.182,95％ CI:1.049-9.653) and abnormal umbilical cord (OR=2.252,95％ CI:1.267-4.004) in overweight group was increased.the risk of pre eclampsia (OR=2.585,95％ CI:1.020-6.914),macrosomia (OR=2.484,95％ CI:1.017 6.070),neonatal electrolyte disorder (OR=4.430,95％ CI:1.290-t5.217) in obesity group was increased.Conclusions The median BMI before pregnancy increased with increasing maternal age,parity,but decreased with education level and income level.The weight gain of early (13 weeks) pregnancy and the total weight gain during whole pregnancy decreased with increasing BMI.Overweight and obesity before pregnancy increased the risk the caesarean section,preeclampsia,gestational diabetes,macrosomia and neonatal electrolyte disorder.
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Objective To formulate a five-level pediatric emergency triage standard and evaluate the efficacy and reliability of it in determining severity of emergency pediatric patients.Methods According to the assessment methods in Pediatric Advanced Life Support recommended by American Heart Association and American Academy of Pediatrics,we formulated a five-level pediatric emergency triage standard based on the situation of our hospital and analyzed the data one year before and after the application of it.Results Before and after the application of the triage standard,the average satisfaction rate of emergency patients were (81.28 ± 3.97) ％ and (94.13 ± 4.62) ％,and there was significant difference (P ＜ 0.01) ; the proportion of whom became worse during waiting time were 1.83％ (628/34275) and 0.04％ (16/36 187),and there was significant difference (P ＜0.01) ;the average waiting time of emergency admission patients were (12.71 ± 2.32) min and (3.34 ± 1.95) min,and there was significant difference (P ＜0.01) ;the misjudgment rate of severity were 3.78％ (1 296/34 275) and 0.57％ (205/36 187),and there was significant difference (P ＜ 0.05).Conclusion The five-level triage standard is objective,easy to master,and suitable for pediatric triage.It can quickly sort out critical cases from emergency pediatric patients,which can improve the effectiveness of emergency service,make use of medical resources rationally and somewhat solve the problem of overcrowding.
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Objective To compare the skills level before and after pediatric advanced life support course and analyze the effect of the training. Methods The pediatric advanced life support was used as the textbook. The skills were got through attending theory classes, watching demonstrations and taking part in the simulator training. The questionnaires were filled strictly and the data was analysed. Results The test scores were increased after the training (P＜0. 01). There were only 8.7% of the trainees had used the rescue equipments and 61.3% had never seen the rescue equipments before training. More than 80% of the trainees were satisfied with the training about the utility and novelty. Conclusion pediatric advanced life support course can successfully deliver a large number of healthcare providers with international unique pediatric emergency treatment skills ,and raise the participants abilities of rescuing critical children.
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Most solid materials in nature consist of minerals, they are ubiquitous on the surface of the earth. After inhaled in body, they will trigger pulmonary disease. The pathogenesis of mineral dusts is always in the way of disputing and consummating. Researcher should pay great attention to the adverse effect of mineral dust in nonprofessional environment. The biological action of mineral surface is an important aspect to discover mineral dust interface function and molecular toxicological mechanism. At present, the superfine mineral dust and nanometer suspending dust are the important components of dust environment safety assessment.