Effect of comprehensive nursing based on evidence-based nursing on reducing the incidence of pressure ulcers in patients undergoing posterior orthopedic surgery.

To analyze the effect of comprehensive nursing based on evidence-based nursing during the perioperative period on reducing the incidence of pressure ulcers in patients undergoing posterior orthopedic surgery. Data on 120 patients who underwent orthopedic posterior surgery in our hospital from February 2021 to December 2022 were retrospectively analyzed. The patients were divided into an observation group (n = 60) and a control group (n = 60) based on different nursing methods. Patients in the control group received routine nursing, whereas those in the observation group received comprehensive nursing under the guidance of the concept of evidence-based nursing. The incidence of postoperative pressure ulcer was also recorded. Fasting venous blood (5 mL) was collected from patients before and after surgery and used to measure levels of myeloperoxidase (MPO) and superoxide dismutase (SOD) using enzyme-linked immunosorbent assay. Ulcer tissue samples of patients with pressure ulcers were collected and used to detect the expression of caspase-3 protein, vascular endothelial growth factor (VEGF) mRNA, tumor necrosis factor-α (TNF-α) mRNA, and interleukin-1ß (IL-1ß) mRNA. The incidence of postoperative pressure ulcers was 8% in the observation group and 23% in the control group (P = .024). The scores of sensory perceptions of the patients in the observation group were significantly lower than those in the control group (P < .001), as were the scores for moisture (P < .001), activity (P = .008), mobility (P < .001), nutrition (P = .003), friction, and shear (P < .001). After surgery, the serum MPO level in the observation group was significantly lower than that in the control group (P < .001), whereas the SOD level in the observation group was significantly higher than that in the control group (P < .001). The expression of TNF-α, IL-1ß, VEGF mRNA, and caspase-3 protein in pressure ulcer tissues in the observation group was significantly lower than that in the control group. Comprehensive nursing based on the concept of evidence-based nursing can significantly reduce the incidence of postoperative pressure ulcers following posterior orthopedic surgery.

Comprehensive competitiveness assessment of four typical municipal sludge treatment routes in China based on environmental and techno-economic analysis.

To find a sustainable and effective municipal sludge treatment route requires a systematic assessment of the comprehensive competitiveness of diverse sludge treatment routes. Four typical treatment routes in China including co-incineration in coal power plants (CIN), mono-incineration (IN), anaerobic digestion (AD) and pyrolysis (PY) were selected in this study. A novel assessment model integrating life cycle assessment (LCA), techno-economic analysis (TEA) with analytic hierarchy process (AHP)-Entropy method was established, and comprehensive competitiveness indicated by comprehensive index (CI) of the four routes was deeply evaluated. Results displayed CIN route (CI = 0.758) showed the best comprehensive performance for its best environmental and economic performance. This was followed by PY route (CI = 0.691) and AD route (CI = 0.570), indicating the enormous potential of sludge PY technology. IN route showed the worst comprehensive performance (CI = 0.186) owing to its high environmental impact and lowest economic benefit. It was noted that greenhouse gas emissions and severe toxic potential were the main environmental challenges faced by sludge treatment. Besides, result of sensitivity analysis revealed that the comprehensive competitiveness of diverse sludge treatment routes was improved with the increase of sludge organic content and sludge reception fee.