Application of 6S and PDCA cycle lean management in nursing management of orthopedic trauma surgery / 中华创伤杂志

Objective:To explore the application effect of 6S and PDCA cycle lean management in nursing management of orthopaedic trauma surgery.Methods:A retrospective cohort study was conducted to analyze the clinical data of 80 patients with orthopedic trauma admitted to University-Town Hospital of Chongqing Medical University from January 2020 to November 2021, including 51 males and 29 females; aged 23-68 years [(44.5±9.2)years]. According to the order of operation date, 40 patients from January 2021 to November 2021 received routine management plus 6S and PDCA cycle lean management (lean management group), and 40 patients from January 2020 to December 2020 received routine surgical nursing management (routine management group). The nursing quality score in operating room (instrument and equipment management, surgical instrument preparation, surgical coordination, disinfection and isolation), qualified rate of infection monitoring in operating room (air in operating room, hand hygiene of medical staffs and sterile articles in operating room), surgeons′ satisfaction with operating nurses (circulating nurses and scrub nurses), self- rating anxiety scale (SAS) of patients before operation, incidence of complications at postoperative 12 days and patients′ satisfaction with nurses in operating room at postoperative 2-3 days.Results:The four dimensions of the nursing quality score in operating room in lean management group were (27.8±1.5)points, (18.1±1.1)points, (26.6±1.5)points and (18.1±0.8)points, significantly higher than (23.7±2.3)points, (14.6±1.1)points, (22.4±1.8)points and (13.7±1.1)points in routine management group (all P<0.01). The three dimensions of qualified rate of infection monitoring in operating room in lean management group were all 100%, showing no significant differences in routine management group (75%, 100%, 100%) (all P>0.05). Surgeons′ satisfaction with circulating nurses and scrub nurses in lean management group was 90% and 85%, higher than 73% and 65% in routine management group (all P<0.05). Preoperative SAS in lean management group was (32.5±8.2)points, significantly lower than (54.6±10.7)points in routine management group ( P<0.01). The incidence of postoperative complications in lean management group was 0, significantly lower than 15%(6/40) in routine management group ( P<0.05). Patients′ satisfaction with nurses in operating room in lean management group was 95% (38/40), significantly higher than 78%(31/40) in routine management group ( P<0.05). Conclusion:6S and PDCA cycle lean management can effectively improve the nursing quality of orthopedic trauma surgery, reduce patients′ anxiety and postoperative complications, and improve surgeons′ and patients′ satisfaction, which is worthy of further clinical application.

Association between Maternal Drug Use and Cytochrome P450 Genetic Polymorphisms and the Risk of Congenital Heart Defects in Offspring / 生物医学与环境科学（英文）

OBJECTIVE@#This study aimed to assess the associations between maternal drug use, cytochrome P450 ( CYP450) genetic polymorphisms, and their interactions with the risk of congenital heart defects (CHDs) in offspring.@*METHODS@#A case-control study involving 569 mothers of CHD cases and 652 controls was conducted from November 2017 to January 2020.@*RESULTS@#After adjusting for potential confounding factors, the results show that mothers who used ovulatory drugs (adjusted odds ratio [a OR] = 2.12; 95% confidence interval [ CI]: 1.08-4.16), antidepressants (a OR = 2.56; 95% CI: 1.36-4.82), antiabortifacients (a OR = 1.55; 95% CI: 1.00-2.40), or traditional Chinese drugs (a OR = 1.97; 95% CI: 1.26-3.09) during pregnancy were at a significantly higher risk of CHDs in offspring. Maternal CYP450 genetic polymorphisms at rs1065852 (A/T vs. A/A: OR = 1.53, 95% CI: 1.10-2.14; T/T vs. A/A: OR = 1.57, 95% CI: 1.07-2.31) and rs16947 (G/G vs. C/C: OR = 3.41, 95% CI: 1.82-6.39) were also significantly associated with the risk of CHDs in offspring. Additionally, significant interactions were observed between the CYP450genetic variants and drug use on the development of CHDs.@*CONCLUSIONS@#In those of Chinese descent, ovulatory drugs, antidepressants, antiabortifacients, and traditional Chinese medicines may be associated with the risk of CHDs in offspring. Maternal CYP450 genes may regulate the effects of maternal drug exposure on fetal heart development.

Association between maternal reduced folate carrier gene polymorphisms and congenital heart disease in offspring: a case-control study / 中国当代儿科杂志

OBJECTIVE@#To study the association between maternal reduced folate carrier (@*METHODS@#A hospital-based case-control study was conducted. The mothers of 683 infants with CHD who attended the Department of Cardiothoracic Surgery, Hunan Children's Hospital, from November 2017 to March 2020 were enrolled as the case group. The mothers of 740 healthy infants without any deformity who attended the hospital during the same period of time were enrolled as the control group. A questionnaire survey was performed to collect the exposure data of subjects. Venous blood samples of 5 mL were collected from the mothers for genetic polymorphism detection. A multivariate logistic regression analysis was used to evaluate the association of @*RESULTS@#After control for confounding factors, the multivariate logistic regression analysis showed that maternal @*CONCLUSIONS@#Maternal

Effect and function analysis of sulfentanyl on tongue cancer in patients with postoperative analgesia / 中国生化药物杂志

Objective To investigate the effect and function analysis by sulfentanyl in patients with tongue cancer postoperative analgesia.Methods A total of 74 patients with radical resection of tongue cancer in department of anesthesiology with general anesthesia from our hospital were collected, patients or their families signed consent, according to postoperative self-controlled intravenous analgesia drugs divided into experimental group and control group with 37 cases in each group.Patients in control group were treated by fentanyl self-controlled intravenous analgesia;patients in experimental group were treated by sulfentanyl self-controlled intravenous analgesia, determination of the analgesic effect, sedative effect and the changed of vital signs postoperative 2, 4, 8, 12, 24, 48 h,at the same time recorded complications.Results After operation, at different time points analgesic effect and sedative effect were changed in the two groups, the VAS scored of the experimental group was lower than the control group postoperative 2, 4, 8, 12, 24, 48 h time points, the Ramsay Sedation scored of the experimental group was lower than the control group postoperative 2 h, 4 h, 8 h, 12 h time points ( P 0.05 ) . Conclusion Sulfentanyl in the treatment of patients with radical resection of tongue cancer the analgesic effect and sedative effect are better than fentanyl, has no effect on the vital signs, and the role is security and exact.

Application on the thickness of nerve fiber layer of the optic disc in pathologic myopia eyes by OCT / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the application on frequency domain optical coherence tomography ( OCT ) technology of pathologic myopia optic disc neurosensory retinal thickness changes and its relationship with axis oculi, sex and age, and help for the early diagnosis of pathological myopia and primary open angle glaucoma. METHODS:Collected 96 eyes of normal eyes ( axis oculi 23-24mm) and 153 eyes of pathologic myopia eyes ( axis oculi 25-27mm 80 eyes, >27mm 73 eyes). We measured the thickness of nerve fiber layer of the optic disc by OCT and analyzed their relationship with axis oculi, sex and age with multiple linear regression analysis. RESULTS: The observation group showed significant smaller average thickness of peripapillary, superior, inferior, nasal than the control group ( P0. 05); The partial correlation coefficient of peripapillary average thickness of nerve fiber layer and axis oculi was -1. 31, gender was 5. 21, age was -0. 12. CONCLUSION:The thickness of nerve fiber layer of the optic disc in the pathologic myopia eyes are decreased than normal eyes, axis oculi, sex and age are influenced factors. The pathologic myopia patients should use different index combined with optic nerve fiber layer thickness decreased to help for the diagnosis of early primary open angle glaucoma.