Objective To explore the effect of quality control circle (ACC) on the management of material in the operation room. Method QCC team was established in operation room to consistently improve the location and position of material, and standards of locating and positioning the material were established. Results Through the application of QCC, the satisfaction rates of nurses and doctors were higher than those before QCC. The preoperative time for material preparation after the application of QCC was significantly shorter than that before (P<0.01). Conclusion Through the implementation of QCC, the locations of material in the operating room are standardized, and the quality of operating room management and nurses'work efficiency both improved.

Objective To summarize the experience of nursing cooperation for immediate breast reconstruction with the latissimus dorsi myocutaneous flap. Methods Twenty breast cancer patients underwent modified radical surgery with intraoperative immediate application of the latissimus dorsi myocutaneous flap in combination with the same period breast prosthesis for breast reconstruction. The nursing measures included preoperative preparation and mental support, intraoperative active cooperation, position care, sustaining of body temperature and strict aseptic and disease-free technology. Results All the breast cancer patients lived through breast cancer modified radical immediate breast reconstruction. No flap necrosis occurred , neither did obvious complications. The operations were satisfactory. Conclusion The key to the breast reconstruction for the breast cancer patients exists in preoperative psychological nursing , intraoperative strict aseptic and disease-free technology , the proper operation position and the correct use of instruments and equipment.

Objective To analyze the application effect of disposable surgery retractor which made of high polymer medical plastic.Methods From January 2016 to October 2016,80 patients of HCC who were treated with hepatectomy under general anesthesia in our hospital were randomly divided into the control group and the observation group according to different retractor during surgery.The control group used the traditional abdominal retractor during the sugery.Meanwhile,the observation group used disposable surgery retractor.The application effect between the two groups were compared.Results The satisfaction rate of surgical exposure and effect in surgeon of the observation group were higher than those of the control group.The wound pain time of patients in perioperative period and 1 month after surgery and chronic pain incidence in postoperative 6 months between the two groups were evaluated.It turned out that the difference in average pain score was statistically significant (P<0.05).Conclusion The disposable surgical retractor can improve the satisfaction rate of surgeons with better surgical exposure,and it can significantly reduce the damage of wound tissue,which effectively relieves the postoperative pain,shortens the time of postoperative pain,and reduces the incidence of chronic pain.

Objective To investigate the causes of hypothermia in severe trauma patients as well as the effects of warming nursing.Methods Toally 100 severe trauma patients with hypothermia were engaged in the study during January to December 2014.Their temperature was monitored and recorded,the causes analyzed so that the warming nursing measures were done to them.Results Among the 100 patients,59 contracted hypothermia,with the rate of 59.0％ before operation,28 contracted hypothermia during operation,with the incidence rate of 28.0％.The causes of hypothermia included injury,anaesthesia,exposure and fluid resuscitation.The nursing measures included pre-treatment before anaesthesia,avoidance of more exposure and intraoperative warming.Conclusions For the patients with severe trauma,the hypothermia during the operation can be caused by injury,anaesthesia,exposure and fluid resuscitation.The warming nursing can reduce the incidence of hypothermia so as to increase their survival rate.

OBJECTIVETo assess the platelet and plasma concentrations of fibronectin (Fn) and fibrinogen (Fg) in congenital fibrinogenopenic (FgP) patients and explore their role in inducing platelet adhesion and aggregation.

METHODSA FgP family was selected as study group and the platelets isolated and purified to assess concentrations of Fn and Fg in platelets, alpha-granules and plasma with Western blotting, immuofluoresence staining and flow cytometry (FACS), respectively, the expression of platelets GP II b/III a by FACS.

RESULTSThe concentration of platelets Fn in FgP patients is higher than that in controls, and is higher in homozygote than in heterozygote. In contrast, plasma Fn levels were identical in all samples. The amount of platelet Fg from FgP patients is lower than that from the controls and positively correlated with the concentration of their plasma Fg. No difference in the expression of platelet GP II b/III a had been found.

CONCLUSIONIt suggested that increased platelet Fn could partially compensate the lack of Fg and lead the platelet adhesion and aggregation.

Afibrinogenemia ; congenital ; metabolism ; pathology ; Blood Platelets ; metabolism ; pathology ; Cell Adhesion ; physiology ; Female ; Fibrinogen ; genetics ; metabolism ; Fibronectins ; blood ; genetics ; metabolism ; Heterozygote ; Homozygote ; Humans ; Male ; Pedigree ; Platelet Aggregation ; physiology ; Platelet Membrane Glycoproteins ; metabolism

There is a high incidence of venous thrombosis in patients undergoing gynecological surgery, which causes symptoms as limbs swelling, edema and pain. Postoperative recovery of patients is delayed and financial burden is increased More seriously, the obstruction of pulmonary artery by deep venous thrombosis is fatal and always leads to the death of patients. The article provides a theoretical basis for the prevention of venous thrombosis by reviewing the risk factors and risk assessment for venous thrombosis in patients undergoing gynecological surgery and related research progress.

Objective:To explore the construction and clinical practice of the training system for nurses in operating room subspecialty based on ORTCC model (including objectives, rules, training, assessment and culture), and to provide theoretical and practical guidance for the development of nursing subspecialty in operating room.Methods:This was a quasi-experimental study. The Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology was convenient to select 23 operating room nurses who rotated in orthopedic surgery rooms from January 2019 to June 2020 as the control group, and the traditional training model for specialized nurses in operating rooms was adopted. From July 2020 to December 2021, the 24 operating room nurses rotating orthopedic surgery rooms were selected as the experimental group, and ORTCC teaching mode was adopted. The degree of mastery of theoretical knowledge, standardization of operation skills, correct rate of standard preventive implementation and satisfaction rate of doctors of operating room nurses under two different training methods were compared.Results:The theoretical score of operating room nurses increased from (84.71 ± 5.70) points in the control group to (92.68 ± 3.64) points in the experimental group, and the skill score increased from (90.17 ± 4.69) points in the control group to (95.43 ± 2.61) points in the experimental group, with statistical significance ( t = 13.76, 5.64, both P<0.01). The satisfaction rate of surgeons to nurses′ surgical cooperation ability communication, cooperation ability and emergency treatment ability increased from 82.61%(19/23), 73.91%(17/23) and 78.26%(18/23) in the control group to 100.00%(24/24), 95.83% (24/24) and 100.00% (24/24) in the experimental group, respectively, with statistically significant differences ( t = 4.56, 4.45, 5.84, all P<0.05). Conclusions:The training system of operating room subspecialty nurses based on ORTCC model is conducive to improving the theoretical knowledge mastery, standard operation skills and doctor satisfaction rate of operating room nurses to the specialty and subspecialty, providing training basis for the development of operating room subspecialty, and worthy of clinical promotion.

Objective To explore the effective measures for the stability of micro-environmental indicators in clean operating department.Methods Professionals of clean technology were invited to participate in unit operation and maintenance of management.Besides, operating room managers conducted regular sampling analysis of five micro-environmental indicators, including temperature, humidity, differential pressure, illumination and decibel, in 100-level, 1 000-level, 10 000-level, 100 000-level clean operating rooms, and compared the test results with parameters of target environmental indicators regulated in national standards.Then the test results of annual bacteria subsidence from different operating rooms in clean operating department were compared.Results Under the management of professionals, the values of temperature, humidity, differential pressure, illumination and decibel from micro-environment in 100-level, 1 000-level, 10 000-level, 100 000-level clean operating rooms were in accordance with rated values in the industry with ( P>0.05);the annual bacteria subsidence in 100-level, 1 000-level, 10 000-level, 100 000-level clean operating rooms in 2013 was in accordance with the standards specified in GB50333 and clearly less than rated values.Conclusions Professional participating in the management and maintenance of micro-environment in clean operating department and irregular supervision and sampling test by operating room managers, the micro-environmental indicators in operation department can be well controlled.

Objective To study the effects of perioperative body temperature management on intraperitoneal hyperthermic perfusion chemotherapy patients with abdominal malignant tumor. Methods From June to Decmber 2016, a total of 120 intraperitoneal hyperthermic perfusion chemotherapy patients with abdominal malignant tumor who met the inclusion criteria were recruited and randomly divided into control group and observation group, with 60 cases in each. All the subjects were given routine operation nursing. On the basis of that, the observation group were given perioperative body temperature management. The body temperature, heart rate, pulse pressure and the difference of tumor markers of carcineombryonic antigen (CEA) and carbohydrate antigen19-9(CA199) before and after treatment were compared between the two groups. Results The difference value of temperature, heart rate and pulse pressure between 30 minutes after treatment and before treatment in the observation group were (3.7±0.4)℃, (12.4±2.7)bp/min and (5.6±1.9)mmHg respectively. The fluctuation of vital signs was lower than the control group, and the differences were statistically significant (t=6.062, 14.897, 10.392; P<0.01). The observation group patients' CEA was (52.8±2.4)μg/L, and CA199 was (106.1±5.3)U/ml after treatment, which were both lower than the control group, with statistical differences(t=31.415, 33.803; P< 0.05). Conclusions Perioperative body temperature management could significantly stabilize the body temperature, heart rate and pulse pressure, which could significantly promote intraperitoneal hyperthermic perfusion chemotherapy's curative effect for patient with abdominal malignant tumor.

Objective? To explore the clinical application of information technology in the multidisciplinary chain management of surgical patient handover, in order to reduce the safety hazard in the process of surgical patient handover. Methods? In the contemporary controlled study, 300 patients were selected as the control group from February to July 2017 by cluster sampling, and 303 patients were selected as experimental group from February to July 2018. Traditional sectional handover method was adopted in the control group, to managed the patients＇ handover from each section. In the experimental group, based on the information communication platform between the surgery room and relevant clinical departments, by clinical electronic documents chain transfer method, quality inspection and supervision information feedback technology, to achieve shared decision and improvement of patients handover problems, we built the multidisciplinary management pattern. The two groups were compared for statistical difference from six aspects:the rate of acceptance specification, the accuracy of identity verification method, the rate of operation labeling verification, the accuracy of inventory of items, the evaluation of pipeline patency, and the evaluation of skin condition at the compression site. Results? The rate of standard delivery of surgical patient handover increased from 49.33% to 92.08% in the two groups. The experimental group was better than the control group in the rate of correct delivery of handover from the following five aspects: identity recognition, indication of surgical site, inventory of articles carried, unobstructed pipeline and skin state of the pressure site with statistical significance (P＜ 0.01). Conclusions? The multidisciplinary chain management model of surgical patient handover supported by information technology is effective in clinical application, which can significantly reduce the risk of hazard in patient handover and is worthy of clinical promotion.