Multivariate analysis and nursing intervention strategies for intraoperative pressure ulcers in patients undergoing craniocerebral microsurgery.

OBJECTIVE: This study aimed to investigate the various influencing factors for intraoperative pressure sores in patients with craniocerebral microsurgery and provide nursing intervention strategies for surgical pressure sores in a clinical operating room. METHODS: This was a case-control study on 2157 patients who underwent craniocerebral microsurgery in the craniocerebral department of the hospital between November 2021 and November 2022. Of these, 62 patients with intraoperative pressure sores were compared with 248 patients without pressure sores during the same period using a 1:4 case-control method. A logistic regression model was used to analyze the effect of possible factors on pressure sores in an operating room. RESULTS: The incidence of pressure sores in craniocerebral microsurgery was 2.87%. The logistic regression analysis showed that skin at the pressure site [odds ratio (OR) = 1.759, 95% confidence interval (CI): 1.137-2.721], surgical position (OR = 1.727, 95% CI: 1.338-2.228), intraoperative body temperature (OR = 2.229, 95% CI: 1.229-4.042), and surgical time (OR = 2.009, 95% CI: 1.221-3.303) were independent factors for the occurrence of intraoperative pressure sores. CONCLUSIONS: The high-risk factors for pressure sores in craniocerebral microsurgery included fasting time, surgical position, intraoperative temperature, and skin at the pressure site. Targeted attention and protection had a positive effect in preventing intraoperative pressure sores in patients who underwent craniocerebral microsurgery.

Urinary stem cell-derived exocrine circRNA ATG7 regulates the SOCS1/STAT3 signaling pathway through miR-4500, inhibits M1 macrophage polarization, and alleviates the progression of diabetes nephropathy.

OBJECTIVE: The etiopathogenesis of diabetes nephropathy (DN) has not yet been fully clarified. Finding effective treatments to prevent renal failure in DN patients has become the main focus of research in recent years. Circular RNA (circRNA) has been shown to play a momentous role in DN progression. Based on this, we aimed to investigate the potential mechanism by which urine-derived stem cell (USC)-derived exosome circRNA ATG7 (Exo-ATG7) mediates DN progression. METHODS: Exosomes from USCs were isolated and identified. The DN rat model was established by intraperitoneally injecting 60 mg/kg streptozotocin. The protein expression levels were measured by Western blot and immunofluorescence. HE and Masson staining were used to evaluate renal injury, and the expression of related genes was detected by RT-qPCR. RESULTS: CircRNA ATG7 was significantly downregulated in the DN rat model, and the extracellular vesicles of USCs improved renal function and reduced inflammation in DN rats. However, after knocking down the USCs-derived exosome circRNA ATG7, improvement and therapeutic effect on renal function in DN rats were lost. In addition, overexpression of ATG7 facilitated the switching of macrophages from the pro-inflammatory M1 phenotype to the anti-inflammatory M2 phenotype both in vivo and in vitro. Mechanistically, upregulation of circRNA ATG7 expression can alleviate renal damage in DN rats. Importantly, the USCs-derived exosome circRNA ATG7 promotes macrophage M2 polarization by regulating the SOCS1/STAT3 signaling pathway through miR-4500. In addition, animal experiments also confirmed that after knocking down ATG7 in USC cells, the extracted exosome-treated DN rats could weaken the therapeutic effect of USC exosomes. CONCLUSION: Our research results indicate that USC-derived exosomal circRNA ATG7 facilitates macrophage phenotype switching from M1 to M2 through the SOCS1/STAT3 signaling pathway mediated by miR-4500, thereby inhibiting DN progression.

Risk factors for intraoperative pressure injuries in patients undergoing digestive surgery: A retrospective study.

AIM AND OBJECTIVE: To investigate the incidence of intraoperative blanchable erythema and pressure injuries in patients undergoing digestive surgery and to explore potential risk factors. BACKGROUND: Pressure injuries pose significant economic and healthcare burden to patients and are used as one of the key indicators of nursing in the operation room with high incidence. DESIGN: A retrospective observational study. METHODS: Basic information and the results of 3S intraoperative risk assessment scale of pressure injury were obtained from the information system. And the patients with intraoperative blanchable erythema or pressure injuries were followed up for 72 hr by the information system. The clinical data were collected to analyse risk factors for intraoperative blanchable erythema and pressure injuries by univariate analysis and logistic regression analysis. STROBE checklist for cohort studies was applied in the preparation of the paper. RESULTS: Of 5,136 surgical cases, 134 (2.61%) had blanchable erythema, 37 (0.72%) had intraoperative pressure injuries, and 8 (0.16%) had pressure injuries at 72-hr follow-up. Preoperative skin under compression, preoperative physical activity, surgical position and extra intraoperative pressure were considered independent risk factors for intraoperative pressure injuries. CONCLUSION: The incidence of pressure injuries in our study was lower than those reported in the previous studies. Accessing preoperative skin under compression, preoperative physical activity, surgical position and extra intraoperative pressure was considered to be significant for preventing pressure injuries. RELEVANCE TO CLINICAL PRACTICE: The findings suggest that preoperative skin under compression, preoperative physical activity, surgical position and extra intraoperative pressure are associated with intraoperative pressure injuries in patients undergoing digestive surgery.

Design and research on reliability-validity for 3S intraoperative risk assessment scale of pressure sore.

The reliability and validity of risk assessment scale (RAS) of pressure sore during 3S surgery were investigated. RAS of pressure sore was designed independently during 3S surgery. Five operating room nursing experts were selected to consult and detect face validity. Convenient and purposive sampling of 707 samples was conducted. Cronbach's alpha was used to measure content reliability and evaluate the internal consistence of RAS. The structural reliability was investigated by exploratory factor analysis method. The results showed that the content validity index was 0.92, and Cronbach's alpha of content reliability was 0.71. Structural validity, detected by Bartlett sphericity test, was 135.3 for 707 samples with the difference being statistically significant (P<0.01). KMO value was 0.729. The accumulative variance contribution ratio of common factor was 64.63%. The exploratory factor analysis showed the factor load of every clause was larger than 0.596. It was concluded that RAS of pressure sore for 3S surgery has better validity and reliability, and it could be used for evaluating and screening the high risk patients with pressure sores during surgery in order to efficiently reduce the occurrence of pressure sore during surgery. RAS of pressure sore for 3S surgery is worth to be popularized.