Objective To investigate and analyze the present situation of continuing nursing education in our hospital, so as to implement data based delicacy management. Methods A total of 119 nurses were recruited by stratified sampling method from June 2016 to August 2016, and were investigated using a self-designed questionnaire including the understanding of continuing education system, the demands for training, the training effect and the supervisors' situation in continuing education in each department in Beijing Friendship Hospital, Capital Medical University. Results The median score of 79 general nurses' knowledge about continuing education system was 7 (6, 7). The investigation of the needs for continuing education training showed that most of the respondents (82.35%) had the demands for classⅠand classⅡcredit training. There was no statistical difference in credit category demands among the respondents with different titles, education backgrounds and length of service (P> 0.05). The investigation of subject category showed that there was no statistical difference among the respondents with different titles, education backgrounds and length of service (P> 0.05). All the respondents expressed that continuing education contributed to the improvement of professional level and the expansion of knowledge, and there was no significant difference among the respondents with different titles, education backgrounds and length of service (P>0.05). In the investigation of supervision, the frequency of using the continuing education management software was generally at a low level, mainly concentrated at 3-4 times/year. However, most credit supervisors (77.50%) could regularly check the department members' credit completion situation. Conclusions Nurses do not know much about the continuing education system. The systematic training of continuing education should be strengthened in the whole hospital, and various kinds of courses should be provided. The directors in charge of each department were supposed to strengthen the supervision. It is of great significance to set up a hierarchical supervision for delicacy management.

Objective:To investigate the feasibility and therapeutic effect of total knee arthroplasty (TKA) with cruciate-retaining (CR) prosthesis by using FEM-X1 femoral extramedullary positioning instrument based on the theory of restricted kinematic alignment (rKA).Methods:Thirty five cases who underwent total knee arthroplasty in Nanjing Drum Tower Hospital from November 2019 to December 2020 were retrospectively analyzed, including 7 males and 28 females with an average age of 71± 8 years (ranging from 55 to 85 years) Following the guidance of rKA alignment, the FEM-X1 femoral extramedullary positioning instrument was used for TKA with CR prosthesis. Before the operation, the full-length lower limb radiographs of both anteroposterior and lateral views were taken in a standing position for preoperative assessment of lateral distal femoral angle (LDFA), the medial proximal tibial angle (MPTA) and hip-knee-ankle angle (HKA). According to the principle of rKA alignment, the target LDFA, MPTA and HKA were calculated. The proximal end of tibia and distal end of femur were cut using extramedullary positioning instrument respectively. The posterior femoral condyle was cut according to the tibial plateau and mediolateral soft tissue tension. The prosthesis was installed after osteotomy. The release of collateral ligaments, PCL function, release of PCL, patellofemoral trajectory, release of patellofemoral support band, the amount of blood loss and time of operation were recorded. Postoperative LDFA, MPTA, HKA, and posterior slope angle of tibial prosthesis were measured on X-ray images. The Knee Society Score (KSS) was used for functional evaluation.Results:Thirty five cases of TKA with CR prosthesis following rKA alignment were successfully completed. The operation time was 100 (90, 110) min, and the blood loss was 100 (100, 200) ml. 30 of them were followed up for 12.5±0.7 months (ranging from 12 to 14 months). The pre-operative and post-operative LDFA were 1.0°(-2.0°, 4.0°), 0°(-2.0°, 2.0°), MPTA were -4.0°(-5.0°, -1.0°), -2.0°(-3.0°, -1.0°), HKA were -3.0°(-3.0°, -1.0°), -2.0°(-3.0°, -1.0°). There was no significant difference between the three angles before and after operation ( Z=-0.89, P=0.372; Z=1.87, P=0.061; Z=1.03, P=0.302). The average posterior tibial slope was 5°(3°, 7°). At the follow-up of one year, the KSS clinical score was 94(92, 97) and functional score was 80(70, 90) in 30 cases. During the operation, PCL was released in 1 case because of excessive tension; and lateral retinacular release was performed in 1 case because of poor patellofemoral track. Conclusion:ITKA with CR prosthesis by using the extramedullary positioning instrument on the theory of rKA alignment showed a good clinical outcome at a short follow up.