Objective To discuss about the application of early restricted fluid resuscitation in dealing with thoracic and abdominal trauma combined with hemorrhagic shock.Methods 140 cases of patients with thoracic and abdominal trauma combined with hemorrhagic shock were divided into two groups stochastically,one group was dealt with conventional liquid resuscitation (the control group,71 cases),the other group was treated with limited fluid resuscitation (the limited group,69 cases).The patients of the control group were treated substantial rehydration therapy,the rehydration was carried out quickly and sufficiently in the early before hemostasis,to keep the mean arterial pressure (MAP) at 80～90 mmHg (1 mmHg=0.133 kPa); The amount and velocity of entering liquid of the limited group was under controlled,their MAP was kept at 55～65 mmHg,Adequate fluid resuscitation was carried out after bleeding was stopped.The average amount of infusion,the general situation,the incidences of complications and the death rates of two groups were compared.Results The average amount of infusion in the control group was significantly more than the limited group,the preoperative Hb and HCT of the control group were obviously lower than the limited group,the incidence of complications and the death rate of the control group were higher than the limited group.Conclusions If preoperative restricted fluid resuscitation for traumatic shock was used,the Harassing for Organism's compensatory mechanisms and internal environment could be avoided,the incidence of complications and the death rate will become lower,therefore,this method was worth to be extended in the clinical operation.

Purpose: This study explored the effect of a nursing comprehensive skill training course (NCST-C) on the metacognitive awareness of nursing students to provide a scientific foundation for improving metacognitive awareness. Methods: This study used a quasi-experimental two-group matched pretest, post-test, and follow-up test. Ninety-six junior nursing students were recruited using convenience sampling and assigned to two groups by drawing lots with odd and even numbers in a nursing school at Huzhou University. The control group received a traditional skill-training course. The intervention group received NCST-C.Nursing students' metacognitive awareness inventory (MAI) was evaluated at the baseline, 16-week, and 20-week follow-up points. A repeated-measures analysis of variance and a simple effect test was used to compare each outcome measure of the two groups three times. Results: The NCST-C resulted in greater benefits for nursing students' metacognitive awareness as well as various dimensions (knowledge of cognition and regulation of cognition) in the intervention group.Combined with a simple effects test, the MAI and dimension scores of those in the intervention group significantly improved at 16 weeks after the baseline (F ¼ 9.78e44.03; all ps < .01). The sustainable effect of NCST-C lasted 1 month after the intervention (F ¼ 14.24e62.36; ps < .01), reaching statistical significance (p < .05). Conclusions The NCST-C effectively developed metacognitive awareness among nursing students. Its design provides a new type of experimental course for improving metacognitive awareness.Trial registration: chictr.org.cn: ChiCTR2200057910. First registration date: 1/11/2020.