Objective? To translate the attitudes towards vital signs monitoring scale (V-scale) and to test the reliability and validity of it. Methods? We carried out translation, back-translation and culture adaptation to confirm the Chinese version scale. From March to August 2018, we investigated 420 nurses of general wards from three Class Ⅲ Grade A general hospitals in Beijing with the Chinese version of V-scale. The reliability and validity of the scale was evaluated by exploratory factor analysis, confirmatory factor analysis and internal consistency test. Results? The Chinese version of V-scale had 16 items with 0.93 for the content validity. A total of 5 common factors (workload, operation skill, communication, key indicators and knowledge) were extracted by exploratory factor analysis with 65.724% for the total variance contribution. Confirmatory factor analysis showed that the scale was with the good level of fit indices in each item, and adaptation test values all reached the standard level. The Cronbach's α coefficient of the total scale was 0.761 and Cronbach's α coefficients of all dimensions ranged from 0.579 to 0.809. The retest reliability of the scale was 0.778. Conclusions? The Chinese version of V-scale has the good reliability and validity which could be used to assess ward nurses' attitudes towards vital signs monitoring to identify disease progression in China.

Objective To investigate the effect of ultrasound-guided erector spinae plane (ESP) block on early postoperative pain and stress response in patients undergoing thoracoscopic lobectomy. Methods Sixty American Society of Anesthesiologists statusⅠorⅡgrade patients who had underwent thoracoscopic lobectomy from June to December 2018 in Wenzhou People′s Hospital were selected. The patients were divided into combined group 1, combined group 2 and control group according to the random digits table method with 20 cases each. The patients in control group only received patient controlled intravenous anesthesia (PCIA) after surgery. While in combined group 1 and 2, unilateral ESP block was performed before skin cutoff or after surgery under the guidance of ultrasonography, respectively, to replenish PCIA administration. The mean arterial pressure (MAP), heart rate, plethysmography index (SPI), state entropy (SE) and reaction entropy (RE) before anesthesia induction, immediately after intubation, at the time of incision, and thoracoscopic cannulation, 30 min after surgery, and at the time of thoracoscopic cannula withdrawal were recorded. The visual analogue score (VAS) at rest and cough extubation immediately and 1, 6, 12, 24, 48 h after extubation were recorded. The compression number of analgesia pump, remedy number of sufentanil and incidence of adverse events 48 h after extubation were recorded. The levels of venous blood norepinephrine (NE), epinephrine (E) and cortisol immediately after surgery and 24 h after extubation were measured. Results Sixty patients completed the study. There were no statistical difference in intraoperative fluid volume, operation duration, MAP, heart rate, SPI, RE, SE, incidence of adverse events (nausea vomiting, urinary retention and itching) and remedy number of sufentanil (P＞0.05). Compared with control group, the rest VAS from extubation immediately to 48 h after extubation and cough VAS from extubation immediately to 24 h after extubation in combined group 1 and 2 were significantly lower than those in control group, and there were statistical differences (P＜0.05). The compression numbers of analgesia pump 1 to 24 h after extubation in combined group 1 and 2 were significantly lower than those in control group: 1 (0, 1) and 1 (0, 1) times vs. 3 (2, 4) times, 2 (1, 3) and 1 (0, 2) times vs. 5 (2, 7) times, 3 (1, 4) and 3 (2, 5) times vs. 6 (3, 7) times, 1 (0, 1) and 2 (1, 3) times vs. 4 (2, 6) times, 4 (2, 5) and 4 (2, 5) times vs. 6 (3, 8) times, and there were statistical differences (P＜0.05). Immediately after operation ending, the NE, E and cortisol in combined group 1 were significantly lower than those in control group and combined group 2: (32.7 ± 7.3) ng/L vs. (88.7 ± 11.3) and (80.5 ± 13.4) ng/L, (44.5 ± 9.9) ng/L vs. (59.3 ± 10.2) and (55.6 ± 11.6) ng/L, (4.0 ± 2.6) mg/L vs. (25.4 ± 6.8) and (18.9 ± 5.3) mg/L, and there were statistical differences (P＜0.05); there were no statistical differences between control group and combined group 2 (P＞0.05). The NE, E and cortisol 24 h after extubation in combined group 1 and 2 were significantly lower than those in control group:(52.3 ± 11.8) and (56.5 ± 14.4) ng/L vs. (160.6 ± 21.7) ng/L, (52.2 ± 13.6) and (51.8 ± 10.5) ng/L vs. (90.3 ± 20.5) ng/L, (6.2 ± 2.1) and (9.4 ± 5.3) mg/L vs. (40.8 ± 9.2) mg/L, and there were statistical differences (P＜0.05), there were no statistical differences between combined group 1 and combined group 2 (P＞0.05). Conclusions The ultrasound-guided ESP block combined with PCIA can provide favorable postoperative analgesia for thoracic surgery, and ESP block before skin incision, but not after chest closing, can provide better effects in reducing stress response.

Objective To explore the best time window of intake and output volume observation after partial nephrectomy and its predictive value for acute renal injury. Methods The information of totally 134 renal cancer patients with regular subsequent visits after partial nephrectomy in Peking Union Medical College Hospital from December 2014 to December 2015 were collected. The intake and urine volume per hour was recorded. The receiver operating characteristic (ROC) curve was used to explore the best time wind of intake and output volume observation and its predictive value for acute renal injury in patients with partial nephrectomy. Results Acute renal injury was found in 19.4% of the 134 patients. The differences between intake and output volumes 10, 14, 16 and 18 h postoperatively in the acute renal injury group were bigger than those in the non acute renal injury group (P＜0.05). According to the multiple regression analysis, the intake and output volume 10 h postoperatively and the time of warm ischemia were the independent risk factors to postoperative renal injury (P＜0.05). The intake and output volume 10 h postoperatively had predictive power to acute renal injury, whose area under the ROC was 0.747 (95%CI:0.592-0.903, P＜0.05). Conclusions The intake and output volume 10 h postoperatively may be the best time window for observing the intake and output volume in patients with acute renal injury after partial nephrectomy.

Objective To compare anesthetic effects between erector spinae plane block(ESPB)and intercostal nerve block(ICNB)in thoracoscopic lung wedge resection guided by surgical pleth index(SPI).Methods A total of 46 patients who underwent thoracoscopic lung wedge resection in Wenzhou People's Hospital from July 2020 to June 2022 were selected and divided into ICNB group and ESPB group according to random number table method,with 23 cases in each group.Remifentanil infusion rate,propofol dosage and intraoperative vital signs were compared between two groups.Results The intraoperative remifentanil infusion rate in ESPB group was significantly lower than that in ICNB group(P<0.05).There was no significant difference in intraoperative propofol dosage between two groups(P>0.05).The SPI,bispectral index and mean arterial pressure in ESPB group during lung wedge resection were significantly lower than those in ICNB group(P<0.05).There was no significant difference in heart rate between two groups(P>0.05).Conclusion Under the guidance of SPI,patients undergoing thoracoscopic lung wedge resection with preoperative ESPB had low opioid consumption and stable vital signs.