Venous thromboembolism is a serious complication of the patients undergoing orthopaedic surgery.Effective diagno-sis and assessment are important methods to predict venous thromboembolismand decrease the incidence of venous thromboenbolism . This paper summaries the advantages and disadvantages of subjective and objective assessment tools to help doctors and nurses find the patients with high risk in the early stage,take individual prevention,and decrease the incidence of venous thromboembolism.

BACKGROUND:Compliance of mechanical device reduced in the prevention of deep venous thrombosis.
OBJECTIVE:To evaluate the compliance on mechanical prevention measures in the prevention of deep venous thrombosis, and to analyze the reason for compliance reduction.
METHODS:We searched Cochrane Library, PubMed, Embase, and Medline for articles on compliance of inpatients on mechanical device for prevention of deep vein thrombosis published from inception to December 2015. At the same time, the“snowbal”method was used to screen the references. After the literatures were screened, using the Newcastle Ottawa Scale tools and Agency for Healthcare Research and Quality standard, two researchers evaluated the quality of the literatures independently and strictly. Data were extracted if meet the discharge standard. The software of Meta-analyst Beta3.13 was used for heterogeneity analysis and publication bias test in the extracted data. According to the heterogeneity analysis results and literature types, a reasonable statistical analysis method was selected to col ate, summarize and discuss.
RESULTS AND CONCLUSION:Final y, 12 papers were included, 9 of which were cross-sectional studies, 2 cohort studies, and 1 case-control study. The odds ratio about compliance rate of inpatients with mechanical devices was 53.2%(95%CI:38.7-67.2). Subgroup analysis showed that the odds ratio about compliance rate of pneumatic compression devices was 54.9%(95%CI:34.9-73.4). The odds ratio about compliance rate on elastic stockings was 47.9%(95%CI:34.3-61.8). The detection of mechanical device of surgical patients showed that odds ratio about compliance rate was 66.8%(95%CI:47.4-81.7). Our results confirm that the compliance rate of the use of mechanical devices for the prevention of deep venous thrombosis in clinical inpatients requests to be improved. The reason for reduced compliance rate should be further investigated to improve the compliance rate.

OBJECTIVECombined the optical principle with automatic control technology and computer real-time image detection technology to develop a non-contact system for noninvasive esophageal varices pressure measurement.

METHODSThe system included the adjustable air pump, laser device, image collection and analysis program. The feasibility and accuracy of the system were verified by in vitro experiments.

RESULTSThe bionic vascular pressure measured by this system had good correlation and repeatability with the actual pressure.

CONCLUSIONSThis system is accurate, feasible and has good application prospects.

BACKGROUND:Tranexamic acid has been more and more used in reducing bleeding after joint replacement, but its usage method and dosage remain controversial, and become a hot focus in recent years. OBJECTIVE: To investigate the efficacy and safety of intravenous drip combined with intra-articular injection of tranexamic acid on postoperative hidden blood loss in patients who received primary total hip arthroplasty. METHODS:Clinical data of 65 patients undergoing primary total hip arthroplasty were randomized to the test group and the control group. The patients in the test group received 0.5 g tranexamic acid through intravenous drip when the surgery starts and 0.5 g tranexamic acid inside hip joint through a drainage tube after capsule closure, and retaining for 6 hours. The patients in the control group intravenously received the same volume of physiological saline, and 50 mL physiological saline through a drainage tube after suture, and retaining for 6 hours. We compared with intraoperative blood loss, postoperative dominant blood loss and hidden blood loss, pain score, blood transfusion rate, deep vein thrombosis and day of hospitalization in both groups. RESULTS AND CONCLUSION:Hemoglobin and hematocrit were higher in the test group than in the control group after replacement (P < 0.05). The volumes of dominant blood loss and hidden blood loss were lower in the test group than in the control group after replacement (P < 0.05). Blood transfusion rate and day of hospitalization were less in the test group than in the control group (P < 0.05). No significant difference in intraoperative blood loss, pain score and incidence of deep vein thrombosis was detectable between the two groups (P > 0.05). These results indicate that the intravenous drip combined intra-articular injection of tranexamic acid in patients receiving total hip arthroplasty could reduce the amounts of postoperative dominant and hidden blood loss and blood transfusion rate, and did not increase the incidence of deep vein thrombosis.

Objective To investigate the application of Critical Care Chest Ultrasonic Examination (CCUE)-plus (CCUE-plus) in the etiological diagnosis in patieuts with dyspnea and/or hemodynamic instability caused by abdominal abnormalities.Methods Patients who suffered from dyspnea and/or hemodynamic instability in the Department of Critical Care Medicine,Xiangya Hospital,Central South University from September 2013 to September 2016 were recruited in this study.A total of 255 consecutive patients completed CCUE within 2hrs of admission.If the diaphragm could not be seen in the routine phrenic points according to Bedside Lung Ultrasound Evaluation (BLUE) protocol,it would be found along midaxillary line and defined m-point.The 59 patients with altered diaphragmatic position (m-point was more than 2 cm higher than phrenic point) received sequential abdominal ultrasonography.The latter ultrasonographic findings were compared with CT results.Results There were 42 (71.19％) cases with positive findings of abdominal ultrasonography,including 18 cases of seroperitoneum,16 cases of intestinal obstruction and 8 cases combined.Compared with 56 patients who applied with CT exam,the abdominal ultrasonography revealed a sensitivity of 76.7％ and a specificity of 100.0％ to diagnose seroperitoneum (AUCRoc 0.917);whereas the sensitivity was 75.0％ and the specificity was 90.9％ (AUCRoc 0.778) to diagnose intestinal obstruction.Moreover,there were 44 (74.58％) patients with normal left ventricular systolic function;more than three quarters (46/59,77.97％) patients had pulmonary consolidation.Conclusion In patients with dyspnea and/or hemodynamic instability caused by abdominal abnormalities and altered diaphragmatic position in BLUE protocol,CCUE-plus protocol has a high positive predictive value of more than 90％ in abdominal abnormality.The findings of abdominal ultrasonography may change therapeutic target from cardio-pulmonary optimization to relief of intestinal obstruction or drainage of seroperitoneum.

Objective To compare predictive power for deep vein thrombosis among hip and knee joint replacement patients using Autar scale and Wells scale.Methods Convenience sampling method was used.Totally 331 patients from ten tertiary hospitals receiving hip and knee joint replacement were recruited.General information questionnaire,Autar scale and Wells scale were used to collect data.Telephone follow-up was performed at 2 weeks,1 month and 3 months after hospital discharge.The primary endpoint of follow-up was occurrence of DVT,and the secondary endpoint was no occurrence of DVT within 3 months after hospital discharge.Results The Cronbach's α coefficients of Autar scale ranged from 0.716 to 0.762 for scores 24h before operation,24h after operation and at the day of discharge,and those of Wells scale ranged from 0.580 to 0.603.The area under the ROC curve of Autar scale ranged from 0.726 to 0.798.The area under the ROC curve of Wells scale ranged from 0.568 to 0.628.Conclusion The predictive power of Autar scale was higher than that of Wells scale which enabled Autar scale to better predict deep vein thrombosis for patients receiving hip and knee joint replacement.

Objective:To explore the status and influencing factors of nurses′ cognitive ability of nursing interruptions in operating room.Methods:From March to May 2020, convenient sampling was conducted, a questionnaire was used to investigate the cognitive ability of operating room registered nurses in some provinces and cities in China. The influencing factors were analyzed by single factor analysis and multiple stepwise linear regression analysis.Results:Finally, 2 827 questionnaires were collected from 1 municipality directly under the central government and 15 provinces, involving 42 municipal and county hospitals. The nurses′ cognitive ability of nursing interruptions in operating room scored 105.73 ± 13.39, which was in the middle level. A total of 2 427 (87.37%) operating room nurses thought it necessary to receive training on nursing interruptions, but only 796 (28.16%) nurses had received training on nursing interruptions. Multiple stepwise linear regression analysis showed that different job categories ( B=-0.714, P<0.001), whether to pay attention to nursing interruptions ( B=5.449, P<0.001), the frequency of experience nursing interruptions ( B=-1.916, P<0.001)and whether to participate in the training of nursing interruptions ( B=-4.806, P<0.001) were the influencing factors of operating room nurses' cognitive ability of nursing interruptions. Conclusions:The operating room nurses' cognitive ability of nursing interruptions is in the middle level. The current situation of training is not good, but the training demand is high. Managers should strengthen the systematic training of nurses on nursing interruptions, especially those with junior nurses in operating room, to improve nurses' attention and cognitive ability of nursing interruptions.

Objective To investigate the characteristics of lung ultrasound images in critical care postoperative patients using BLUE-plus protocol . Methods Two hundred and twenty-two patients who were performed lung ultrasound measurements according to the BLUE-plus protocol within 24 hours admitted to the Department of critical care were included in this study . Data was collected and retrospectively analyzed to compare the proportion of different lung ultrasound signs at different speculate regions ,and to compare the lung ultrasound characteristics of patients undergo different surgeries . Results Excluding A lines ,the most common abnormal lung ultrasound signs at the diaphragmatic points were B7 lines (13 .06％ ) ,and the most common abnormal lung ultrasound signs at the posterior blue points were C signs (28 .60％ ) . The rate of C signs was significantly higher in post spinal cord surgery patients than those in other groups ( P =0 .032) . The rate of B3 lines was significantly higher at bilateral PLAPS points in oxygenation index 100-200 group compared with that in oxygenation index>300 group ( P =0 .011) . The rate of C signs was significantly higher at the left posterior blue point in oxygenation index 200-300 group , and at bilateral posterior blue point in oxygenation index 100-200 and <100 groups compared with those in oxygenation index >300 group ( P =0 .011 , P <0 .001 and P =0 .002) . The rate of pleural effusion was significantly higher at the right posterior blue point in oxygenation index 200 -300 group ,and at bilateral posterior blue point in oxygenation index 100 -200 group compared with those in oxygenation index >300 group ( P = 0 .001 , P < 0 .001 ) . Conclusions Screen with the BLUE-plus protocol can help to find abnormal signs including B3 lines ,B7 lines ,C signs and pleural effusion ,therefore instructs individualized treatment for postoperative patients . Pulmonary edema ,lung consolidation and pleural effusion are three main reasons responsible for hypoxemia in postoperative patients . Intensivists should avoid fluid overload , strengthen airway management ,postural therapy and encourage early mobility in postoperative patients .

Objective To study the influencing factors of primary hypertension by investigating its prevalence in elderly patients of Deang nationality.Methods Nine hundred and thirty-nine elderly patients of Deang nationality were divided into hypertension group (n =353),prehypertension group (n=377) and control group (n=209).Their physical examination data were recorded and their blood pressure was measured.Results The detection rate of hypertension was significantly lower in elderly patients of Deang nationality than in those of the other nationalities in our country with their age ≥60 years (37.6％ vs 49.0％,P＜0.05).The detection rate of hypertension,isolated systolic hypertension and prehypertension increased with the increasing age (P＜0.05).Multivariate logistic regression analysis showed a cross interaction between economic level and alcohol drinking (P＜0.05) and a positive correlation of BMI,age,gender,divorce or widow,smonking,high salt diet with hypertension (P＜0.05).Conclusion The detection rate of hypertension is lower in elderly patients of Deang nationality than in those of the other nationalities in our country.Economic level,alcohol drinking,BMI,age,gender,divorce or widow,smoking,high salt and fat diet are the major risk factors for hypertension.However,regular eating of vegetables can reduce the risk of hypertension.

Objective:To assess the prevalence of metabolic syndrome(MS) and its relationship with hyperuricemia(HUA) in perimenopausal women in Anning city, Yunnan province.Methods:This is a cross-sectional survey. In May 2021, a multi-stage stratified sampling method was used to collect demographics and clinical data [ethnicity, living community, height, weight, waist circumference, blood pressure, fasting plasma glucose, triglycerides(TG), serum uric acid, high density lipoprotein-cholesterol(HDL-C), alanine transaminase(ALT), etc] in a total of 6 721 perimenopausal women aged 45-60 years.Results:A total of 6 721 perimenopausal women were included in this study. The prevalences of MS and HUA were 14.05%(95% CI 13.22%-14.88%) and 6.46%(95% CI 5.88%-7.07%), respectively. The average age, HDL-C, urea, direct bilirubin, and albumin levels in the perimenstrual HUA population were lower than those in the non-HUA population while the levels of TG, ALT, heart rate, body mass index(BMI), and creatinine were higher(all P<0.05). The prevalence of HUA in perimenopausal women with ethnic minorities and family history of chronic diseases was higher than that in Han nationality and without family history of chronic diseases. The prevalence of MS in perimenopausal women was increased with the increase of serum uric acid( Z=-15.313 8, P<0.001). Multivariate logistic regression model showed that HUA was positively correlated with MS( OR=1.526, 95% CI 1.192-1.954) after adjusting for covariates such as BMI and ethnicity, and the incidence of MS in perimenopausal women in HUA group was 1.526 folds higher than that in non-hyperuricemia group. Conclusion:HUA is highly positively correlated with MS in perimenopausal women. The management of uric acid level in perimenopausal women should be strengthened.