Application of Intraoperative Neurophysiological Monitoring (IONM) for Preventing Dysphagia After Anterior Cervical Surgery: A Prospective Study.

OBJECTIVE: To evaluate the clinical value of intraoperative nerve monitoring (IONM) for dysphagia after anterior cervical surgery with and without IONM. METHODS: A prospective, randomized, controlled study was conducted on 46 patients who underwent anterior cervical spine surgery by an experienced orthopaedic surgeon. Twenty-three patients who underwent anterior cervical surgery did not undergo IONM (non-IONM group), while the other 23 patients who underwent anterior cervical surgery did ("IONM group"). The swallowing function of patients was evaluated using the EAT-10 and endoscopic evaluation of swallowing (FEES) after surgery. RESULTS: There was no difference in the incidence of swallowing difficulties between the intervention group and the control group on the third day or sixth week after surgery. At the 12th week after surgery, the incidence of swallowing difficulties in the intervention group and the control group was significantly different (43.5% vs. 13.0%, P = 0.024). CONCLUSIONS: IONM is a promising tool for identifying and protecting the spinal cord and nerves during anterior cervical surgery. Our research revealed that IONM significantly reduced the occurrence of swallowing disorders 12 weeks after surgery, but the effect was not significant at the third or sixth week after surgery.

A multicenter cross-sectional survey of the knowledge, attitude, and behaviour of nurses regarding dysphagia after anterior cervical spine surgery: a prospective multicentre study.

BACKGROUND: The incidence of dysphagia after anterior cervical spine surgery is high, which directly affects the quality of life of patients after surgery. The knowledge, attitude, and behavior of nurses can affect the identification and management of patients after anterior cervical spine surgery. Therefore, we need a survey to understand the current status of nurses' knowledge, attitude, and behavior towards dysphagia after anterior cervical spine surgery. OBJECTIVE: To investigate the knowledge, attitude, and behaviour of orthopaedic nurses towards patients with dysphagia after anterior cervical spine surgery and provide recommendations for management and intervention. METHOD: An online cross-sectional survey was conducted between March and June 2023, which among 894 orthopaedic nurses from 36 tertiary hospitals in Chongqing using a questionnaire. The questionnaire included general information and knowledge, attitudes, and behaviours related to the management of dysphagia after anterior cervical surgery. RESULTS: The orthopaedic nurses' mean score for dysphagia-related knowledge was 16.1 ± 3.640 (out of a total score of 30). The orthopaedic nurses' mean score for dysphagia-related attitude was 32.5 ± 4.623 (out of a total score of 40). The orthopaedic nurses' mean score for dysphagia-related behaviour was 43.6 ± 11.513 (out of a total score of 60). The results of statistical analysis showed that the dysphagia after anterior cervical spine surgery -related knowledge scores differed significantly among the nurses according to, education level, and training (P < 0.05). Correlation analysis showed that there was a positive correlation between the knowledge, attitude, and behaviour scores of neurological nurses and swallowing disorders after anterior cervical surgery (P < 0.05). CONCLUSION: Targeted knowledge and skills training should be carried out to improve the rules and regulations for dysphagia after anterior cervical spine surgery. Multidisciplinary team cooperation is needed, and dietary service processes and management standards should be improved to improve the management ability of orthopaedic nurses for dysphagia after anterior cervical spine surgery.

Symptoms and coping of patients with dysphagia after anterior cervical spine surgery: a qualitative study.

AIM: To explore the subjective symptoms, psychological characteristics and coping strategies of patients with dysphagia after anterior cervical spine surgery, so as to provide the basis for formulating strategies to help patients with dysphagia solve clinical practice problems and to improve their quality of life after surgery. METHODS: Using the phenomenological research method and the purpose sampling method, semi-structured interviews were conducted with 22 participants with dysphagia at 3-time points after anterior cervical spine surgery (7 days, 6 weeks, and 6 months). RESULTS: A total of 22 (10 females and 12 males) patients, with years old ranging between 33 and 78 years were interviewed. When analysing the data, the following 3 categories were extracted from the participant interviews: "Subjective symptoms, Coping style and impact on social life". The 3 categories consist of 10 sub-categories. CONCLUSIONS: The results showed that swallowing-related symptoms may occur after anterior cervical spine surgery. Many patients had developed compensatory strategies to manage or reduce the burden of these symptoms, but lacked professional guidance from health care professionals. Moreover, dysphagia after neck surgery has its unique characteristics, involving the interaction of physical, emotional and social factors, which requires early screening.Healthcare professionals should provide better psychological support in the early or late postoperative period to ensure the improvement of health outcomes and patients' quality of life.

The impact of vaccination on patients with COVID-19 during the wave of Omicron in Shanghai.

Background: The global health has been affected by the COVID-19 pandemic persistently, of which Omicron is currently the predominant variant. However, the impact of vaccination on Omicron remained uncertain. Objective: This study sought to explore the effect of vaccination on patients infected with Omicron. Methods: A retrospective observational cohort was conducted in the largest Fangcang shelter hospital in Shanghai from April 1 to May 30, 2022. The demographics, length of hospital stay, clinical symptoms, the comorbidities and vaccination status were recorded. Clinical outcomes of the vaccinated and non-vaccinated groups were compared and analyzed. Results: Of the 3,119 patients who fulfilled the eligibility criteria and were enrolled in the study, 2,226 (71.4%) patients had received nCoV-19 vaccine while 893 (28.6%) patients had not received it before admission. Patients in the vaccinated group had significantly shorter length of hospital stay than those in the unvaccinated group (15.48 ± 2.708 vs. 15.85 ± 3.102, p < 0.001). More asymptomatic patients were observed in the vaccinated group than the non-vaccinated (70.4 vs. 64.5%, p < 0.001). Further subgroup analysis demonstrated that the older the age, the more significant the difference was (p < 0.005). Conclusions: Vaccination was associated with a significant reduction in the severity of Omicron infection compared with no vaccination. Vaccination appears to make Omicron-infected people with milder symptoms than unvaccinated people. This suggests the potential effectiveness of current vaccines against Omicron.

Design improvement and application of transfer trolley for collection and distribution in central sterile supply department / 医疗卫生装备

Objective To modify the existed transfer trolley for collection and distribution so as to enhance cleaning and disinfection.Methods The existed transfer trolley was added with an intake pipe,a spray nozzle,a drilled divider,a drainage pipe and etc for perfusion rinse,and equipped with auxiliary mechanisms such as a protective support and preserver.Omnidirectional cleaning and disinfection of the trolley were executed by the intake pipe,nozzle and high-pressure irrigation machine.Results The trolley prevented the disinfection solution from spitting,ensured the safety of the staff and environment,and had the qualified rate of disinfection being 100％.Conclusion The modified transfer trolley gains advantages in environmental protection,energy saving and practicability,and thus is worthy promoting clinically.

Construction of core competence evaluation index system for orthopaedic specialized nurse / 重庆医学

Objective To establish core competence evaluation index system of orthopaedic specialized nurse .Methods Alto‐gether 35 experts from Class Ⅲ Grade Ⅰ hospital in Chongqing ,Beijing ,Jiangshu were consulted by a three‐round delphi survey ,and finally established the core competence evaluation index system of orthopaedic and the weight of each index .Results The core com‐petence evaluation indexes of orthopaedic specialized nurse included 4 first class indexes ,14 second class indexes and 72 third class indexes .The expert authority coefficient was 0 .833 ,the familiar coefficient was 0 .794 ,the determination coefficient was 0 .872 ,The coordination coefficient of primary and secondary and third indicators were 0 .390 ,0 .324 ,0 .308 ,respectively ,and there were statis‐tically significant differences (P< 0 .05) .Conclusion The expert opinions for the core competence evaluation indexes are consist‐ent ,the results are objective and scientific .It can provide quantitative standards for training ,examining and evaluation of orthopaedic specialized nurse .

Validity of shifts management by group schedule comprising doctors,nurses and sanitary cleaners simultaneously on the basis of echelon allocation in Ebola Treatment Unit of China / 重庆医学

Objective To evaluate the validity of shifts management by group schedule comprising doctors,nurses and sanita-ry cleaners simultaneously on the basis of echelon allocation in Ebola Treatment Unit(ETU)of China.Methods According to the characteristics of Ebola infectious disease prevention and control,working schedule was designed basing on the medical staff compo-sition,working duration and job responsibilities.The validity of this schedule was evaluated by hospital admission time,discharge time,PPE supplies consumption,the error frequence of PPE wearing or uncoating and staff satisfaction.Results Through this mode of shift management,hospital admission time and discharge time were shortened,PPE supplies consumption and the error fre-quence of PPE wearing or uncoating were decreased,the satisfaction degree were improved among doctors,nurses and sanitary cleaners(P <0.01).Conclusion The application of this new style working schedule could ensure the nursing services to be procee-ded safely and smoothly.

The application of nursing procedure in the patient′s care of Ebola virus disease / 重庆医学

Objective To explore the application and clinical effects of nursing procedure of in the patients of Ebola virus dis-ease (EVD).Methods We went on nursing assessments to the 5 EVD patients by applying nursing procedure and made the nursing diagnosis based on the results of nursing assessments.Then we analyzed the possible reasons of common nursing problems and made anticipated goals and carried out the nursing strategies.We evaluated the efficiency of nursing eventually.Results We carried out nursing procedures in 5 EVD patients.No complication was occurred in all patients.Three patients fully recovered and dis-charged from our hospital.We got a good treatment results and achieved good social benefits.Conclusion System nursing to EVD patients,which accords to nursing procedure,helps us reducing the nursing complications,and decreasing the mortality of patients.

Design and practice of multimodal phased protective training for medical staff in the Chinese Ebola Treatment Unit / 重庆医学

Objective To investigate the methods and effects of multimodal and phased protective training for medical staff against Ebola.Methods The 4 stages of the protective training include the theoretical teaching,track type simulative process train-ing,simulative ward training,on-site training.We combined the 4 protective training stages and made 4 protective skills assessments in sequence.Results The average scores and qualified rates of the medical staff in the second,third,fourth assessment increased significantly comparing with that in the first assessment.The qualified rate reached 100% in the fourth assessment and we realized zero infection during the mission.Conclusion Multimodal phased protective training reinforced the protective skills of medical staff.Zero infection of medical staff needed seamless supervision in work time eventually.

Heparanase expression in bladder transitional cell carcinoma and its correlation with clinical pathological features / 第三军医大学学报

Objective To explore the expression of heparanase(HPA)and its correlation with the clinical pathological features and angiogenesis in bladder transitional cell carcinoma.Methods HPA mRNA level was detected with RT-PCR and its protein level was determined by immunohistochemical staining in 68 cases of bladder cancer and 24 cases of adjacent tissues of bladder cancer.Results The positive rate of HPA mRNA was 60.3%(41/68)in bladder cancer,4.2%(1/24)in the adjacent tissues of bladder cancer.The expression of HPA mRNA had statistically significant correlation with pathological stage,clinical staging and lymphonode metastasis(P