Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures (version 2023) / 中华创伤杂志

Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.

Combined aerobic and resistance exercise training for improving rehabilitation in spinal scoliosis / 中国实用护理杂志

Objective To explore the effect of combined aerobic and resistance exercise training on the quality of life, pain degree and hospital stay of spinal scoliosis patients. Methods A total of 112 patients were selected from January 2016 to March 2018, thereby assigning two groups randomly (56 cases). Patients in the control group was nursed by conventional training methods and traditional health education. The experimental group was added combined aerobic and resistance exercise training. The quality of life, pain degree on the first day of admission, 1 week, 1 month and 3 months after operation was evaluated by Scoliosis Research Society-22(SRS-22) and Visual Analogue Scale(VAS),the hospital stay was observed and compared between the two groups. Results There was no significant difference of SRS-22 score and VAS score on the first day of admission between the two groups (P>0.05). The score of VAS was 7(6.25,8.75), 4(3.25,5.00) points in 1 week, 1 month after operation in the experimental group, 8(7.00, 9.00), 5(3.00, 6.00) points in the control group, and there was significant difference between the two groups (Z=4.380, 3.318, P<0.01). The score of SRS-22 was (71.32±10.31), (65.96±6.01), (50.40±7.82) points in 1 week, 1 month, 3 months after operation in the experimental group, (74.64 ± 6.86), (68.16 ± 5.43), (66.42±7.65) points in the control group,and there was significant difference between the two groups (t=2.312, 1.286, 4.508, P<0.01 or 0.05). The hospital stay was (19.30±7.21) d in the control group, (16.70± 5.43) d in the experimental group, and there was significant difference between the two groups (t=1.321, P<0.05).Conclusions Combined aerobic and resistance exercise training is effective at decreasing the degree of pain in post operation, improving quality of life and shorting average of length of stay.

Treatment for thoracolumbar spinal burst fracture in youth and middle-aged adults by bone cement filling / 中南大学学报(医学版)

OBJECTIVE@#To verify whether the procedure of posterior instrumentation and vertebroplasty for treatment of thoracolumbar burst fracture in youth and middle-aged patients is safe, practical and effective in short- and long-term.
@*METHODS@#A total of 50 patients aged 30-55 years old who suffered from thoracolumbar burst fracture complicated with incomplete paralysis or without neurologic symptom received surgery by using pedicle-screw implantation, reduction and bone cement filling through the unilateral or bilateral pedicles. The bone cement injection was conducted slowly and cautiously under monitor of fluoroscopy. Spinal canal exploration or decompression was performed regularly in follow-ups by X-ray films and CT scans.
@*RESULTS@#Cement leakage occurred in 5 cases without relevant symptom, including 1 case with leak from anterior aspect, 2 cases from lateral aspect, and 2 cases through ruptured end-plate into disc space. No spinal canal leakage or introvascular leakage was detected. The following-up duration was 5 to 10 years. There was no vertebral body height loss and regional kyphosis. The gaps within fractured vertebral body prior to surgery were disappeared completely. There was also no cement-bone interface detected. In 15 out of 50 cases, there were newly-formed bone bridges between fractured vertebral body and upper or lower adjacent vertebral body. There was no hardware failure occurred up to final follow-up.
@*CONCLUSION@#Bone cement filling combined with posterior instrumentation through pedicle-screw technique is a safe, practical and effective method for treatment of non-osteoporotic thoracolumbar spinal burst fractures without severe neurologic injury. The gaps among fracture fragments can be filled evenly and completely. Therefore, instant and permanent spinal stability can be achieved with excellent long-term result.

The design and application of electronic preoperative preparation checklist / 中国实用护理杂志

Objective To design and formulate a electronic preoperative preparation checklist for applying in the preoperative preparation,to reduce missing rate in preoperative preparation and transfer,to improve patient satisfaction,to avoid operation delay and medical accident caused by inappropriate preparation.Methods A total of 145 patients with surgery from March 2013 to February 2013 were as experimental group,and 158 patients with surgery from March 2012 to February 2012 were as control group.The experimental group was used electronic preoperative preparation checklist for preoperative preparation and transition,and the control group was used conventional methods.The incidence of mistake for preoperative preparation and transfer and both surgeon's and patient's satisfactory were compared between two groups.Results After applying the electronic preoperative preparation checklist,the incidence of mistake for preoperative preparation and transfer in experimental group reduced significandy to 1.37％(2/145) and 4.83％ (7/145),compared with the incidence of control group 6.33％(10/158),11.39％(18/158),and the differences between two groups were statistically different (x2=4.870,4.305,P ＜ 0.05).Both surgeon's and patient's satisfactory were improved dramatically,the satisfactory in experimental group improved to 100.00％(50/50)and 97.93％(142/145),compared with the satisfactory of control group 90.00％(45/50) and 90.51％(143/158),and the differences between two groups were statistically different(x2=5.263,7.459,P ＜ 0.05).Conclusions Implementing the electronic preoperative preparation checklist can reduce the incidence of mistake before operation and ensure patient operation schedule.Therefore,it could improve nursing care quality and efficiency.

Self-management behaviors in patients with osteoarthritis / 中南大学学报(医学版)

Good self-management behaviors can control symptoms of the patients with osteoarthritis, improve the patients' joint function and quality of life. Patients' self-management behaviors have been impacted by disease knowledge, self-effcacy, emotional state, and social support. All the above factors should been taken into full consideration when intervening. Self-management program is an intervention mode which can improve patient self-management behaviors and promote patient health.