Objective? To investigate the status of readiness for hospital discharge(RHD)in patients after total hip arthroplasty(THA)and to explore the influencing factors. Methods? A total of 161 patients undergoing THA in 3 ClassⅢ Grade A hospitals in He'nan Province during July of 2017 to October of 2018 were selected by convenience sampling method. General Information Questionnaire, RHD Scale, Hospital Anxiety and Depression Scale(HADS), and Harris Hip Score(HHS) were used in the survey to investigate their readiness of hospital discharge. Single factor analysis and multiple stepwise regression analysis were used to analyze the influencing factors of patients' discharge readiness. Results? The RHD of patients after THA was (94.56±10.31). Multivariate stepwise regression analysis showed that education level, disease type, anxiety score and hip joint score were the main influencing factors of discharge readiness (P＜ 0.05), which together explained 34.2% variances of RHD. Conclusions The readiness of discharge in patients after THA is at a moderate level, suggesting that doctors and nurses should pay more attention to patients with low educational level, poor psychological status, slow recovery of joint function and acute fracture in clinical work.

Objective : To study diagnostic value of ultrasonic cardiography (UCG) for right heart occupying lesions (RHOL).Methods :A total of 48 RHOL patients ,who were diagnosed in our hospital from Jan 2014 to Jun 2017 , were selected .All patients received UCG and pathological examination to determine lesion location and type .With pathological examination as gold standard ,diagnostic coincidence rate of UCG for RHOL type was analyzed .Re‐sults :RHOL distribution :compared with superior&inferior vena cava ,there were significant rise in percentages of RHOL located at right atrium ,right ventricle and pulmonary artery (6.25% vs.31.25%, 29. 17%, 33. 33%) , P＜0.01 all.RHOL type :percentage of malignant occupation was significantly higher than those of thrombus and myxoma (54.17% vs.20. 83%, 25.00%) , P＜0. 01 both .With pathological examination as gold standard ,diag‐nostic coincidence rates of UCG for thrombus ,malignant occupation and myxoma were 80.00%, 92. 86% and 100% respectively ,there was no significant difference among them , P＝0. 220 .A total of 18 cases (37.50%) with peri‐cardial effusion were found by UCG ,including two cases (4. 16%) who were diagnosed as benign thrombotic lesion by pathological examination ,and the other 16 cases (33.33%) were caused by malignant RHOL invading right heart system ,which included two cases (4.16%) of essential RHOL and 14 cases (29. 17%) with malignant lesion heart metastasis from other sites .Conclusion :RHOL type mainly includes thrombus ,malignant occupation and myxoma , and malignant occupation possesses relatively high incidence rate ,and it usually comes from malignant tumor metas‐tasis from other sites .Accuracy of UCG is high in diagnosing RHOL ,which is worth extending .

Objective To analyze the nursing cost effectiveness of non-indwelling bladder catheter in thora-coscopic sublobectomy,and in order to further determine the feasibility of patients undergoing sublobectomy without indwelling catheter.Methods We prospectively collected the clinical data on a total of 254 patients undergoing thoracoscopic sublobectomy in the department of pulmonary surgery of Guangdong Provincial People's Hospital from May 2021 to January 2023.The patients were randomly divided into a study group(128 patients without catheter)and a control group(126 patients with catheter).The nursing cost-effectiveness indexes and postoperative comfort scores were compared between the two groups.Results Seven patients in the experimental group and sixteen patients in the control group needed repeated placement of urinary catheter There were no significant differences in the general demographic and clinical data between the two groups(P>0.05).The cost of materials related to urinary catheter,nursing cost,and total cost in the control group were higher than those in the study group.The total nursing time in the control group was longer than that in the study group.The per capita material cost,nursing cost and total cost in the control group were higher than those in the study group,and the differences were statistically significant(P<0.01).The total score of the comfort scale and the physiological and environmental dimension of postoperative comfort were significantly higher in the study group than in the control group,with statistical significances(P<0.05).Conclusions Thoracoscopic sublobectomy without indwelling bladder catheter can lower medical expense,reduce nursing workload,and improve postoperative comfort.

【Objective】 To retrospectively analyze the irregular antibodies in 6 blood group systems other than the Rh blood group system in 53 pregnant women and analyze its correlation with the occurrence of hemolytic disease of the newborn(HDN). 【Methods】 19 473 pregnant women were screened for irregular antibodies by microgel detection technology combined with anti-human globulin (IgG+ C3d), and the positive samples screened out were further confirmed to understand the types and titers of irregular antibodies. Irregular antibody type determination experiment: IgG type irregular antibody titer was determined after mercaptoethanol (2-Me) inactivated the serum of the irregular antibody positive specimen, and then IgG and IgM type were determined by comparing the titer levels of irregular antibody. Three hemolysis tests and total bilirubin tests were performed on umbilical cord blood during delivery to analyze the level of jaundice and the occurrence of HDN. 【Results】 53 cases of irregular antibodies other than the Rh blood group system were detected in 19 473 pregnant women, with a positive rate of 0.27%, mainly MNS and Lewis blood group system.The incidence of HDN was 39.6% (21/53). There were 27 cases of IgM, 7 IgG, and 19 IgM + IgG. Comparison of total bilirubin detection between the low titer group (≤8) and the high titer group (>8) : the latter was significantly higher than the former (P<0.05); IgG antibody subtypes: IgG1 of the latter significantly increased (P<0.05), and so was IgG3 in former (P<0.05). There was a significant positive correlation between IgG1, IgG3 and total bilirubin. The area under the curve of IgG1+ IgG3 for HDN diagnosis, the sensitivity and specificity were 0.953, 0.900, and 0.967, respectively. 【Conclusion】 Other than Rh blood group system, irregular antibodies are mainly distributed in MNS and Lewis blood group system. The incidence of HDN is higher in Kell, Duffy and Kidd blood group systems after producing irregular antibodies. Non-antibody types are mostly IgM type or IgM + IgG mixed, and the incidence of HDN is not high; Patients with poor maternal history, either high or low titer, can be classified into IgG1 and IgG3 in early stages, and those with Abnormal results should be included into the perinatal management of high-risk women with regular checking.