Objective To compare the effectiveness and safety of continuous and intermittent ice compression therapy following total knee arthroplasty surgery. Methods Eighty patients were divided into two groups receiving continuous or intermittent 30 minutes every 2 two hours within 48 hours after the operation. The subjective pain (VAS score), additional pain-killer use, swelling of extremity, drainage, range of motion were observed and compared. Results Patients in the observation group had less pain than those in the control group (Z values in the first 3 postoperative day was-2.722,-3.359,-2.039, respectively, P<0.05). Less pain-killers were required in the experimental group (Z=-2.559, P<0.05). The postoperative swelling by the thigh circumferences in the first day in the observation group was (1.84 ± 1.11) cm, which was milder than the (3.30 ± 1.69) cm of the control group (t=4.565, P<0.01). So was it in the calf circumferences, (0.94 ± 0.89 ) cm vs. (1.46 ± 0.91) cm (t=2.627, P=0.01). Within the first 3 days after the operation, this mildness still existed in aspect of thigh circumferences, which was (3.09±1.39) cm in the observation group vs the (4.09 ± 1.71) cm in the control group, t=2.869, P < 0.01. Conclusions Continuous ice compression therapy has better effects than intermittent 48 hours after total knee replacement, with functional training and exercise not disturbed. It is considered safe and assured, and is therefore recommended.

Objective To explore the application of “PBL -Seminar” teaching method in nursing teaching for undergraduates majoring in nursing.Methods 54 nursing undergraduates from July 2012 to April 2013 were set as control group receiving the traditional teaching method, and another 52 nursing undergraduates from July 2013 to April 2014 at internship were set as experimental group, receiving “PBL -Seminar” teaching method, and then the two groups were compared in terms of teaching effects.Results The patient satisfaction was obviously improved, and the qualification rate of the nursing students and the comprehensive evaluation score were significantly higher as com-pared with the control group (p <0.5).Conclusion “PBL -Seminar” teaching method can effectively improve the effect of the nursing internship of nursing undergraduates and the teaching quality for the nursing undergraduates.

Objective To investigate the current situation of preoperative nursing trust in total knee replacement patients and analyze the influencing factors.Methods Using convenience sampling method,138 patients who underwent total knee ar-throplasty in our department from October 2020 to September 2021 were selected as the research objects.The patients were inves-tigated by general information questionnaire,nurse-patient relationship trust scale(NPTs),self-rating Anxiety Scale(SAS)and knee American Special Surgery scale(HSS),to explore the current situation and influencing factors of patient-nurse trust in pa-tients undergoing total knee arthroplasty.Results The total score of preoperative trust of patients(136.75±7.93);Pearson correlation analysis showed a negative correlation with total anxiety score(r =-0.419,P＜0.01)and no correlation with knee function score(r=0.063,P＞0.05).The results of the multiple linear regression analysis showed that the educational level,previous experience of hospitalization,and preoperative anxiety entered the regression equation(P＜0.05)explained 66.9% of the total variation.Conclusion In this group,the trust between nurses and patients in patients undergoing total knee arthroplas-ty is at the upper middle level,and is affected by education level,previous hospitalization experience and preoperative anxiety.Nurses should focus on patients with low education level,no previous hospitalization experience and high anxiety level,and carry out targeted intervention for theme,so as to reduce postoperative anxiety and improve postoperative function,Promote doctor-pa-tient relationship,reduce medical disputes and help patients recover as soon as possible.

Objective To evaluate the psychometric properties and the clinical feasibility of Chinese version of the Oxford Knee Score in patients with knee osteoarthritis before total knee arthroplasty.Methods One hundred and fourteen (91 females,23 males) preoperative patients with knee osteoarthritis were recruited.Internal consistency was tested using Cronbach's alpha coefficient,and dimensionality was evaluated using exploratory factor analysis.The correlations between the scale,namely,WOMAC,SF-8 and EQ-5D were used to determine construct validity.The floor and ceiling effects were also examined.Results The scale showed acceptable internal consistency (Cronbach's alpha=0.885) and demonstrated good convergent and divergent validity with the moderate to strong correlations between the scale and WOMAC (r=-0.80),the SF-8 physical component summary (r=0.65),and the EQ-5D usual activities (r=-0.41) and mobility (r=-0.35).Moreover,the strong correlation between the scale and the SF-8 mental component summary (r=0.58),as well as the moderate correlation between the scale and the EQ-5D anxiety/depression (r=-0.35) were observed.Divergent construct validity was supported by weak correlation between the scale and EQ-5D VAS (r=0.30).The exploratory factor analysis yielded three factors with eigenvalues ＞ 1,accounting for 66.02％ of the variance.All items had factor loadings above 0.4.Factor 1 closely relates to physical function,while factor 2 depicts pain associated with knee osteoarthritis.Factor 3 had only one item (item 8),reflecting the patient's sleep problems.No sign of floor or ceiling effect was found.Conclusion Chinese version of the Oxford Knee Score is proven to be a reliable,valid scale for knee osteoarthritis patients before total knee arthroplasty.

[Objective] To explore the incidence and risk factors of blood transfusion undergoing total knee revision (TKR) using a nationwide database. [Methods] A retrospective data analysis was conducted based on the Nationwide Inpatient Sample (NIS), enrolling patients who underwent TKR from 2015 to 2019 with complete information. Patients under 18 years old and those using anticoagulants, antiplatelets, antithrombotic and non-steroidal were excluded. The patients were divided into two groups based on whether they received blood transfusion or not. The demographic characteristics, length of stay (LOS), total charge of hospitalization, hospital characteristics, hospital mortality, comorbidities and perioperative complications by Wilcoxon rank test for continuous data and chi-square test for categorical data. Logistic regression was performed to identify risk factors of blood transfusion undergoing TKR. [Results] The NIS database included 63 359 patients who underwent TKR. Among them, 5 271 patients received blood transfusion, with an incidence of blood transfusion of 7.8%. There was a decrease in the incidence over the years from 2015 to 2019, dropping from 10.2% to 6.5%. TKR patients requiring transfusions had experienced longer LOS, incurred higher total medical expenses, utilized Medicare more frequently, and had increased in-hospital mortality rates (all P<0.001). Independent risk factors for blood transfusion included female gender, iron-deficiency anemia, rheumatoid disease, collagen vascular disease, chronic blood loss anemia, congestive heart failure, coagulopathy, diabetes with chronic complications, lymphoma, fluid and electrolyte disorders, peripheral vascular disorders, renal failure, valvular disease and weight loss (malnutrition). In addition, risk factors for transfusion in TKR surgery included sepsis, acute myocardial infarction, deep vein thrombosis, gastrointestinal bleeding, heart failure, pneumonia, urinary tract infection, acute renal failure, postoperative delirium, wound infection, lower limb nerve injury, hemorrhage, seroma, hematoma, wound rupture and non healing. [Conclusion] Our findings highlight the importance of recognizing the risk factors of blood transfusion in TKR and establishing corresponding clinical pathways and intervention measures to reduce the occurrence of adverse events.

OBJECTIVE: To assess the value of Ploton silver staining and phalloidin-iFlour 488 staining in observation of the morphology of osteocyte dendrites of mice at different developmental stages. METHODS: The humerus and femurs were harvested from mice at 0 (P0), 5 (P5), 15 (P15), 21 (P21), 28 (P28), and 35 days (P35) after birth to prepare cryo-sections and paraffin sections. HE staining of P35 mouse femur sections served as a reference for observing osteocytes in the trabecular bone and cortical bone. The humeral sections at different developmental stages were stained with Ploton silver staining to observe the morphology of osteocytes and canaliculi, and the canalicular lengths in the cortical and trabecular bones of the humerus of the mice in each developmental stage were recorded. The cryo-sections of the humerus from P10 and P15 mice were stained with phalloidin iFlour-488 to observe the morphology of osteocytes and measurement of the length of osteocyte dendrites in the cortical bone. RESULTS: In the trabecular bone of the humerus of P0-P15 mice, Ploton silver staining only visualized the outline of the osteocytes, and the morphology of the canaliculi was poorly defined. In P21 or older mice, Ploton silver staining revealed the morphology of the trabecular bone osteocytes and the canaliculi, which were neatly arranged and whose lengths increased significantly with age (P21 CONCLUSIONS Mouse osteocyte dendrites elongate progressively and their arrangement gradually becomes regular with age. Ploton silver staining can clearly visualize the morphology of the osteocytes and the canaliculi in adult mice but not in mice in early stages of development. Phalloidin iFlour-488 staining for labeling the cytoskeleton can be applied for mouse osteocytes at all developmental stages and allows morphological observation of mouse osteocytes in early developmental stages.
Animals ; Bone and Bones ; Dendrites ; Mice ; Osteocytes ; Phalloidine ; Silver Staining