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Objective:To analyze the risk factors for residual pain after percutaneous kyphoplasty (PKP) for osteoporotic vertebral fractures (OVF).Methods:Retrospectively analyzed were the patients with OVC who had been treated at Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University by single level PKP from January 2020 to December 2021. They were 40 men and 181 women, with an age of (69.6±8.2) years. By the pain score of visual analogue scale (VAS) on the postoperative day 3, they were assigned into 2 groups: a residual pain group (VAS≥4) and a control group (VAS<4). The general demographics, radiographic and surgical related data of the 2 groups were analyzed by single factor analysis, including their gender, age, bone mineral density, body mass index, glucocorticoid usage, follow-up time, duration of symptoms, fracture location, severity of fracture compression, intravertebral cleft, middle column involvement, thoracolumbar fascia injury, anesthesia method, puncture method, volume of bone cement injected, cement-endplates contact, pattern of cement distribution, cement leakage, vertebral height restoration, preoperative cobb angle and correction of cobb angle. The P<0.1 factors screened were further analyzed by the multivariate logistic regression to determine the final variables. Results:In the present study, 19 patients were assigned into the residual pain group and 202 patients the control group. The univariate analysis showed that body mass index ( P=0.059), intravertebral cleft ( P=0.049) and thoracolumbar fascia injury ( P< 0.001) increased the risk for residual pain. The multivariate logistic regression analysis showed that thora-columbar fascia injury was an independent risk factor for residual pain ( OR=6.127, 95% CI: 2.240 to 16.755, P<0.001). Conclusion:Thoracolumbar fascia injury is an independent risk factor for residual pain after PKP for OVF.
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Objective:To understand the status quo of nutrition knowledge, attitude and behavior of nurses in class A tertiary hospital and its influencing factors, and to provide reference for the development of reasonable and standard nutrition training courses.Methods:The knowledge, attitude and behavior of nutrition of 207 nurses in 28 class A tertiary hospitals from 17 provinces cities on October 25-26, 2019 were investigated Questionnaire on Nutritional Knowledge, Attitude and Behavior Cognition of Nurses.Results:The scores of nurses′ nutritional knowledge, attitude and behavior were (69.70 ± 2.92), (82.76 ± 4.97) and (64.90 ± 4.77) respectively. There were significant differences in nurses′ nutritional knowledge, attitude and behavior at different ages, nursing ages, whether they had children, the highest educational background, department rotation, technical titles, administrative positions, employment methods, article publication, whether they had participated in nutrition training courses and in different regions ( F values were 6.80-60.95, t values were 2.94-7.08, all P<0.05). The main factors affecting nutrition knowledge were region, nursing age, the highest educational background, department rotation and whether they had participated in nutrition training courses ( t values were -6.88-6.73, all P<0.05). The main factors affecting nutritional attitude were region, nursing age and the highest educational background ( t=-2.22, 6.84, 3.21, all P<0.05). The main factor affecting nutritional behavior was nursing age ( t=5.45, P<0.05). Conclusions:Nurses′ nutritional attitude level is excellent, but their mastery of nutritional knowledge and nutritional nursing behavior level need to be improved. Reasonable, scientific and feasible nutritional training courses should be formulated according to the influencing factors of their nutritional knowledge, attitude and behavior, so as to improve nurses′ nutritional knowledge, belief and behavior level and improve the nutritional status and prognosis of hospitalized patients.
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Objective:To understand the current situation of the ideological and political cognition of the postgraduate courses for the master degree of nursing and the analysis of the demand for the ideological and political curriculum of the community nursing, and provide preliminary experience for the integration of ideological and political elements into the teaching practice of community nursing.Methods:Using phenomenological research method, the semi-structured interviews were conducted with 15 full-time nursing master degree postgraduates from Tongji University in Shanghai. Colaizzi 7-step analysis was used to analyze the data.Results:Under the mode of curriculum ideological and political education, the cognition and needs of nursing master students can be summarized into four themes: the deficiency of curriculum ideological and political cognition, changes in professional cognition, recognition of the role and importance of curriculum ideological and political education, expectations and needs of community nursing curriculum ideological and political education.Conclusion:Nursing students with master′s degree have a vague understanding of "curriculum ideological and political". In the future, they can add diversified teaching methods starting from professional quality, humanistic care and patriotism education, so as to make the community nursing curriculum ideological and political concept more popular, and strive to cultivate senior nursing talents with both ability and morality.
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Objective:To investigate the effects with perioperative indicators of different irrigation methods (automatic irrigation pump and gravity-based irrigation) on ureteroscopic lithotripsy.Methods:A retrospective analysis was used to select 150 patients with ureteral calculi in the Second Affiliated Hospital of Ningxia Medical University from January 2018 to September 2018. The patients included 86 males and 64 females, and the median age was 47 years, ranged 23 to 75 years. The patients were divided into two groups: automatic irrigation pump and gravity-based irrigation group, with 75 cases in each group. The time of operation, the rate of stone moving up, the rate of stone remaining, the change of leukocyte and serum creatinine before and after operation, and the incidence of operation complications were compared between the two groups. The measurement data was expressed as Mean±standard deviation ( Mean± SD), and the t-test was used for comparison between groups; the Chi-square test was used for comparison between count data. Results:The operative time of automatic irrigation pump was shorter than that of gravity-based irrigation group [(42.20±17.61) min vs (45.23±16.40) min]. The increase of leukocyte count [(3.83±3.01)×10 9/L vs (4.36±2.97)×10 9/L] and serum creatinine of first day [(63.26±12.46) μmol/L vs (65.64±11.10) μmol/L] in gravity-based irrigation group was significantly higher than that in automatic irrigation pump ( P=0.034, 0.011, 0.002, respectively). There was no significant difference between the two groups in the stone migration rate (5.3% vs 9.3%), stone residual rate (2.7% vs 4.0%), the incidence of intraoperative complications-mucosa injury of ureter (12.0% vs 10.7%), and postoperative complications (urinary tract infection: 4.0% vs 5.3%, mild hydronephrosis: 5.3% vs 6.7%) ( P=0.347, 0.649, 0.797, 0.868, respectively). Conclusions:The automatic irrigation pump can shorten the operation time, and reduce the increase of blood routine leukocyte count and serum creatinine compared with the gravity-based irrigation. There was no difference between the two methods in the rate of stone migration, stone residue, ureter injury, hydronephrosis and urinary tract infection.
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Objective To evaluate the influence of the placement of instant hand disinfectant in compliance and qualified rate of hand hygiene of clinicians.Methods Hand hygiene compliance of clinicians in departments of gyne-cology,obstetrics,and general surgery were observed after the placement of instant hand disinfectant at the door-way of wards,hand specimens were taken to check hand hygiene effectiveness.Results Before and after placement of instant hand disinfectant at the doorway of wards of above departments,hand hygiene behaviors of 300 person-times were observed.Hand hygiene compliance rate among clinicians in department of gynecology,obstetrics,and general surgery increased from 32.33% to 74.33%,33.67% to 85.67%,and 26.33% to 64.00%,respectively(all P <0.001).Each department selected 98 hand hygiene specimens,the qualified rate was 98.98%,100.00% and 94.90% respectively.Conclusion The placement of instant hand disinfectant at the doorway of each ward can effec-tively improve clinicians’hand hygiene compliance and hand hygiene effectiveness.
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BACKGROUND:With excelent biocompatibility and osteoconduction, calcium phosphate bone cement has been used in clinic, but the poor mechanical properties and lack of osteoinduction restrict its further use. OBJECTIVE:To investigate the cytocompatibility and cytotoxicity of a novel drug-carrying composite of bone cement composed of chitosan microsphere, α-tricalcium phosphate and silk fibroin. METHODS:MC3T3-E1 cels were cultured in vitroin minimum essential medium alpha medium (α-MEM), which was supplemented with 10% fetal bovine serum, and 1% streptomycin sulfate, extract of the cement material at concentrations of 100% and 50%, and 6.4 mL/L phenol. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was used to measure cellproliferation and the cytotoxicity was assessed by the activity of lactate dehydrogenase. The MC3T3-E1 cels culturedin vitro were colected and seeded on the composite cement material, and cellmorphology was observed by scanning electron microscope. RESULTS AND CONCLUSION:The extract of composite cement material had no influences on the MC3T3-E1 cellproliferation, showing no obvious cytotoxicity. The scanning electron microscope image showed MC3T3-E1 cels adhered and proliferated wel on the composite cement material composed of chitosan microsphere, α-tricalcium phosphate and silk fibroin, and pseudopodia out of the cels were closely attached to the material surface. In conclusion, the cement composite was proved to have satisfactory cytocompatibility and no obvious cytotoxicity.
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BACKGROUND:Calcium sulfate used in kyphoplasty and vertebrolplasty has good physical and chemical properties, exerts no toxic effects on human body and has the degradation performance. But its main drawback is rapid degradation. OBJECTIVE:To develop a chitosan microsphere with silk fibroin/calcium sulfate cement to prepare drug carrier system. METHODS:Chitosan microspheres were prepared by the emulsion method. Scanning electron microscopy, particle size analysis and swel ing rate were used to study the properties of the microspheres. Different silk concentrations (3%, 6%and 9%) and weight rates (0.5%,1%and 5%) of chitosan microspheres were used to determine the best formula which has the strongest mechanical properties. The composition of this composite bone cement was detected by using X-ray diffraction and Fourier transform infrared spectroscopy. RESULTS AND CONCLUSION:When the concentration of silk fibroin was 6%and weight rate of chitosan microspheres was 0.5%, we could obtain the maximum compressive strength, which was (39.17±1.96) MPa. With this composition, the initial setting time was (12.99±1.63) minutes and the final setting time was (21.55±0.54) minutes. The results from X-ray diffraction and Fourier transform infrared spectroscopy demonstrated that the main phase composition was calcium sulfate, and silk and chitosan were also included. The composite chitosan microspheres exhibited a slightly wrinkled surface, but were stil intact in spherical shape, indicating the preparation of chitosan microspheres/silk fibroin/calcium sulfate cement was reliable and the product had good structures and properties.
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Suggestions to the safety protection of high frequency physiotherapy devices are given. The safety protection of high frequency physiotherapy devices are discussed in aspects of the categories of high frequency radiation, harm from high frequency, ultra high frequency and electromagnetic field to human body, etc.