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ObjectiveTo introduce a fixation technique with the modified levonorgestrel-releasing intrauterine system (LNG-IUS) and evaluate its efficacy in the treatment of adenomyosis patients with previous LNG-IUS expulsion. MethodsA retrospective analysis was done on 22 adenomyosis patients who underwent modified LNG-IUS fixation due to LNG-IUS expulsion at three hospitals from June 2022 to June 2023. The baseline clinical characteristics, operative and postoperative details were collected and analyzed. The Visual analogu scale (VAS) scores and pictorial blood loss assessment chart (PBAC) scores were measured and compared before, 3 and 6 months after the LNG-IUS fixation. ResultsThe mean operative time was (19.51±7.41) min and intraoperative bleeding was (6.71±5.30) mL. Of the patients, 13 were operated under local anaesthesia and the other 9 under intravenous anaesthesia. There were 4 operations performed by a resident doctor, 15 by an attending doctor and 3 by a senior doctor. No intraoperative or postoperative complication was found. The mean follow-up was 11.51 months and no patient had a recurrence of LNG-IUS expulsion during the follow-up period. The mean level of hemoglobin at 1 month after operation was significantly higher than that before (P<0.001). VAS scores and PBAC scores at 3 and 6 months postoperatively were all improved significantly than those preoperatively (P<0.001). ConclusionsEffectively preventing the recurrence of LNG-IUS expulsion, modified LNG-IUS fixation is a safe and efficient method for adenomyosis patients with previous LNG-IUS expulsion. Modified LNG-IUS fixation deserves the clinical application due to its easy operation and wide range of use on women.
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Objective:To explore the nursing work items and the technical difficulty in post anesthesia care unit, so as to provide the basis for accurate calculation of anesthesia nursing workload and reasonable matching of human resources.Methods:The primary and secondary indicators of the nursing working system in post anesthesia care unit were determined through the literature review and group discussion. Delphi method was used to revise the indicators and evaluate the importance and difficulty degree of the indicators. Finally, analytic hierarchy process and linear weighted sum method were used to calculate the weight value and difficulty coefficient of each index.Results:The positive coefficients of the experts in the two rounds were 100.00%, the authority coefficients of the experts were 0.90 and 0.96, the variation coefficients ranged from 0.000 to 0.342 and 0.042 to 0.307, and the Kendall coefficients were 0.239 and 0.273 (both P<0.01). The evaluation index system of the difficulty of nursing work in post anesthesia care unit was finally composed of 10 primary indicators and 85 secondary indicators. The weight of the primary index ranged from 0.016 4 to 0.186 4, and the weight of the secondary index ranged from 0.000 8 to 0.064 3. The standardized difficulty coefficient of the secondary index ranged from 1.02 to 1.59. Conclusions:The evaluation index system of the difficulty of nursing work items in post anesthesia care unit was comprehensive and the difficulty coefficient was in line with the actual clinical work in this study, which provides reference for the follow-up scientific calculation of nursing workload and human resources matching in post anesthesia care unit.
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Objective:To comprehensively retrieve and summarize the best evidence on the prevention of position-related nerve injury in adult patients undergoing general anesthesia, in order to provide evidence-based guidance for standardized position management during general anesthesia surgery in adults.Methods:Clinical decision-making, guidelines, evidence summaries, best practice, practice advisories, systematic reviews, expert consensuses were systematically search in UpToDate, BMJ Best Practice, Guidelines International Network (GIN), Canadian Medical Association: Clinical Practice Guideline(CMA Infobase), National Guideline Clearinghouse (NGC), National Institute for Health and Care Excellence(NICE), Cochrane Library, PubMed, CNKI, Wanfang, and related websites. The literature retrieval period was from the database construction to September 30,2022. The guidelines were independently assessed by 4 researchers, and the remaining literature was independently evaluated by 2 researchers. The literature that met the criteria was extracted. Finally, the expert meeting integrated the evidence and summarized the evidence topics.Results:A total of 17 articles were included, including 6 clinical decision-making, 3 guidelines, 2 practice advisories,5 systematic reviews, and 1 expert consensus. A total of 32 pieces of best evidence and 5 evidence topics were formed: personnel placement, perioperative evaluation, points of surgical position, key points in special surgery or situation, other general principles.Conclusion:This study summarized the best evidence for the prevention and management of surgical position related nerve injuries, and provides a scientific theoretical reference for postural management of adult patients undergoing operation with general anesthesia, to reduce the incidence of nerve injuries related position.
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Objective@#To determine the impact of urination behavior of overactive bladder in female operating room nurses.@*Methods@#A total of 381 female operating room nurses were recruited from three first-class hospitals in Nanjing by convenience sampling method. They were investigated with Chinese version of OAB symptom score scale and Chinese version of urinary behavior scale. The relationship between urination behavior and overactive bladder was analyzed.@*Results@#The total score of overactive bladder female in operating room nurses was 10.05±3.28. There were significant positive correlations between score of urination behavior and score of overactive bladder. Regression analysis showed that the factor scores of urination behavior such as urinary behavior, no urine urination behavior could independently explain 41.3% of the variance for overactive bladder after controlling demographic variables.@*Conclusion@#Clinical managers should focus on the shortcomings of urination behavior of female operating room nurses, and take effective measures to to improve the symptoms of overactive bladder in female operating room nurses.
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Objective To determine the impact of urination behavior of overactive bladder in female operating room nurses. Methods A total of 381 female operating room nurses were recruited from three first-class hospitals in Nanjing by convenience sampling method. They were investigated with Chinese version of OAB symptom score scale and Chinese version of urinary behavior scale. The relationship between urination behavior and overactive bladder was analyzed. Results The total score of overactive bladder female in operating room nurses was 10.05 ± 3.28. There were significant positive correlations between score of urination behavior and score of overactive bladder. Regression analysis showed that the factor scores of urination behavior such as urinary behavior, no urine urination behavior could independently explain 41.3% of the variance for overactive bladder after controlling demographic variables. Conclusion Clinical managers should focus on the shortcomings of urination behavior of female operating room nurses, and take effective measures to to improve the symptoms of overactive bladder in female operating room nurses.
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Objective To investigate the effects of different head positions during operation on wake-up time and quality among ankylosing spondylitis (AS) patients with thoracolumbar kyphosis following pedicle subtraction osteotomy (PSO).Methods Sixty patients were included in this study.All of them,treated with intravenous anesthesia,took the bow-prone position.The patients were randomly divided into two groups:the experiment group where the head was elevated by 10° and the control group where the head was not elevated.The two groups were compared in respect of wake-up time and quality of wake-up test.Results The wake-up time in the experiment group was significantly shorter as compared to that of the control group (1 3.7±2.0 min vs.24.2±2.7min,P<0.05).The wake-up quality was better as well.Conclusion Elevation of the head by 10° can shorten wake-up time and improve the quality of wake-up test during the procedure of PSO for AS patients with thoracolumbar kyphosis.
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Objective To investigate the therapeutic effect of shuxuetong injection on acute ischemic stroke.Methods A total of 120 cases were randomized into a treatment group and a control group, with 60 cases in each. The treatment group was treated with Shuxuetong injection, 6ml added into 250ml sodium chloride injection, once daily; and the control group was treated with Mailuoning injection, 20ml added ionto 250ml sodium chloride injection, once daily. The course of treatments lasted 10 days. Neurologic impairment and the changes of TCM syndrome were observed. Results The efficiency was 61.7% and 43.3% in the treatment group and the control group respectively. TCM Syndrome was obviously improved in the treatment group. Conclusion Shuxuetong injection was safe and effective on AIS.
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Objective To observe the therapeutic effect of periodical treatment of Sanjiexiaopi decoction on hyperplasia of mammary gland during premenstrual phase. Methods 110 cases were randomly recruited into a treatment group and a control group with 55 case in each group. The treatment group was given Sanjiexiaopi decoction 7 days before menstruation, and the control group was given Rupixiao tablet. Both groups received no treatment during menstruation and were treated for three months. Patients in both groups underwent molybdenum target X-ray photographs and infrascan before and after the treatment. Therapeutic effects of the two groups.were compared. Results The total effective rate was 96.4% and 81.8% in the treatment group and the control group respectively. The patients in treatment group showed obvious improvent than the control group in terms of X-ray photographs and infrascan, having statistical significance (P<0.05) . Conclusion Sanjiexiaopi decoction has obvious effects on hyperplasia of mammary gland during premenstrual phase.