Objective To explore the effect of quality control circle on the prevalence of incontinence-associated dermatitis.Methods We set up a quality control circle group,analyzing the current situations,set the goals and analysed the causes of the high incidence of incontinence-associated dermatitis in the ICU after deciding a specific subject and then we developed strategies.The two groups were compared in terms of knowledge on the dermatitis,assessment of the dermatitis risks,the dermatitis-related management and the incidence of incontinence-associated dermatitis.Results After manipulation of the quality control circle,the aims of incontinence dermatitis related knowledge,risks assessment and management process were all achieved.The scores on nurses knowledge on the dermatitis,ability in solving problems,quality control operation,confidence,ability in coordination,and team work spirits were all significantly higher than those before the manipulation of the circle (P＜0.01) and the incidence of incontinenceassociated dermatitis was statistically significantly lower (P＜0.001).Conclusion The management based on the quality control in the ICU of neurology department can effectively reduce the neurology incidence of incontinence-associated dermatitis and improve the nurses professional skills.

Objective To investigate the geometric feature of femoral medullary cavity through CT scanning and it's matching with femoral intramedullary nail,and to analysis the reason for difficulties in implanting distal lock pin.Methods Thirty dried femur specimens were measured through CT scanning,and twenty images were taken evenly according to the total length of shaft of femur from each femur.In each image,the data of the central axis point and eight points around medullary cavity wall in X and Y axes were obtained,which were used to reconstruct the three-dimensional models of medullary cavity,central axis,intramedullary nail by computer software.And the models were overlapped for comparison.Then the coronal and sagittal fold line charts for central axis of medullary cavity were drawn.The inserting process of intramedullary nail was simulated to observe whether the nail would punch out of the medullary cavity wall.Results The central axis of femoral medullary cavity and intramedullary nail were overlapped and compared.They matched well in the coronal plane,but the curves of femoral medullary cavity were larger than those of intramedullary nails in sagittal plane.While simulating the inserting process of intramedullary nail,6 nails punched out of the medullary cavity wall in coronal plane (20％,6/30),so did 13 nails in sagittal plane (43％,13/30).Conclusion Intramedullary nails match well with most of the femoral medullary cavities.However,the anatomic structure of the femoral medullary cavity differs individually.Curves of some femoral medullary cavity are large,which can cause deformation of intramedullary nail,and this is the main reason for the failure of distal locking.

Objective:To investigate the effect of tranexamic acid combined with rivaroxaban on perioperative blood loss in patients undergoing posterior lumbar interbody fusion and its potential benefits.Methods:This is a retrospective study. The clinical data of 90 patients who underwent posterior lumbar interbody fusion for lumbar spinal stenosis or spondylolisthesis at Affiliated Hospital of Jining Medical University between September 2019 and September 2021 were analyzed. These patients were divided into two groups: group A ( n = 46) and group B ( n = 44) based on their medication. Patients in group A received an intravenous infusion of 0.5 g tranexamic acid and 100 mL of 5% glucose injection 15 minutes before the surgical incision. The incision wound was soaked externally with 1 g of tranexamic acid solution for 5 minutes before the surgical incision was closed, and it was suctioned before its closure. Patients in group B received the same procedure, except that oral rivaroxaban was administered 10 mg, once daily, after surgery till 35 days after surgery. The operative time, intraoperative blood loss, and the amount of drainage were recorded. Total blood loss, occult blood loss, incidence of lower extremity deep vein thrombosis, incidence of pulmonary embolism and epidural hematoma, and C-reactive protein levels were determined. Results:There were no significant differences in operative time, intraoperative blood loss, the amount of drainage, total blood loss, and occult blood loss between the two groups (all P > 0.05). Postoperative C-reactive protein levels in group A [29.94 (15.75, 50.25) mg/L] were significantly higher than those in group B [7.89 (4.94, 11.10) mg/L, Z = -5.68; P < 0.05]. Lower extremity deep vein thrombosis, pulmonary embolism, or epidural hematoma did not occur in either group. In group A, one patient was infused with 200 mL of leucodepleted red blood cell suspension, while the other patient received 150 mL of autologous blood transfusion. In group B, two patients were infused with 525 mL and 200 mL of leucodepleted red blood cell suspensions, respectively, while the rest did not require blood transfusion. Conclusion:The combined use of tranexamic acid and rivaroxaban after posterior lumbar interbody fusion does not increase perioperative bleeding, and it has additional anti-inflammatory effects without increasing the incidence of lower extremity deep vein thrombosis and pulmonary embolism, as well as the formation of epidural hematomas and the need for blood transfusion.

Objective To evaluate the biological effect of a kind of protective cover against inhalation of depleted uranium (DU) dust particles. Methods At 1 and 3 d after inhalation of DU dust particles, uranium concentrations in the blood, lung, bronchia, kidney, and liver of the rats in the protected group and non protected group were measured and the efficiency of protection was calculated. Results Uranium levels in all tissues and fluids of the rats in the protected group decreased significantly to 71.2%-96.1% as compared with those in non protected group. Conclusion The protective cover is effective to reduce the harm due to inhalation of DU dust particles.