This paper summarizes the experiences of observation and nursing of postoperative complications in 28 patients underwent orthopedic surgery for correction of severe kyphoscoliosis,the Cobb's angle was(150.0±25.3)°. Postoperative nursing focused on monitoring of patients' vital signs,observation of the feeling and motor function of lower limbs and wound drainage,nursing care of gastrointestinal reaction and respiratory complications. The postoperative complications were controlled effectively after timely treatment. There was no any severe complications of spine-cord injury after stage-II surgery.

OBJECTIVETo explore the relationship between job burnout and cognitive function and the influencing factors of job burnout among medical staff.

METHODSQuestionnaire survey was conducted for 197 medical workers in a grade-three general hospital in Beijing. Maslach Burnout Inventory-General Survey (MBI-GS) was carried out to assess the degree of job burnout among medical staff; Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used to evaluate the overall cognitive function and cognitive situations of different dimensions.

RESULTS(1) There was a certain level of job burnout among medical staff, especially for the emotional exhaustion dimension (13.29 ± 7.67). (2) High level job burnout group (81.08 ± 12.34) scored lower on visual span than low level job burnout group (92.48 ± 19.62), P<0.05. Overall, job burnout had a negative influence on the general cognitive function (P<0.05). (3) The results of regression analysis indicated that, inefficacy was negatively correlated with age (r=-0.162, P<0.05). Job burnout was positively correlated with level of education (r=0.234, P<0.05) as well as exercise frequency (r=0.320, P< 0.001), and emotional exhaustion was correlated with overtime work (r=0.135, P<0.05); Level of job burnout stayed higher among doctors and nurses, compared with administration staff in hospitals (t=2.966, P<0.05).

CONCLUSIONJob burnout of medical staff was relatively in high level; influenced by age, education level, overtime work, exercise frequency and occupational type, job burnout affected the visual span and general cognitive function.

Burnout, Professional ; Cognition ; Hospitals ; Humans ; Medical Staff ; psychology ; Nurses ; supply & distribution ; Physicians ; psychology ; Regression Analysis ; Surveys and Questionnaires

BACKGROUND:Clinical treatment of hemivertebrae-induced congenital scoliosis is a complex medical problem. OBJECTIVE:To find the optimal treatment for hemivertebrae accompanied by congenital scoliosis.
METHODS:Total y 142 hemivertebrae patients who had received surgical treatment in the Department of Orthopedics, the 306 Hospital of Chinese PLA, China from 2010 to 2012 were enrol ed. The main surgical treatment was hemivertebrae resection and bone fusion with internal fixation, apical osteotomy for severe scoliosis and spinal shortening with internal fixation, one-stage posterior thoracolumbar osteotomy with internal fixation, spinal decompression with internal fixation.
RESULTS AND CONCLUSION:After treatment, the average correction rate was 70.9%for scoliosis and 71.7%for kyphosis. The fol ow-up period was 14-35 months, with an average of 23.4 months. By the end of the final fol ow-up, the loss rate for Cobb’s angle was 7.3%for scoliosis and 7.7%for kyphosis. Fol ow-up X-ray films showed bone fusion and internal fixation without loosening, fracture, and decompensation. Implementation of one-stage posterior thoracolumbar osteotomy with internal fixation can effectively correct hemivertebrae-induced kyphoscoliosis to obtain a satisfactory spinal sagittal and coronal balance.

BACKGROUND:Orthopedic osteotomy at the apex of kyphosis is best for treatment of ankylosing spondylitis from a biomechanical aspect, but there is a high risk for intraoperative spinal cord injury.
OBJECTIVE:To explore the clinical efficacy of vertebral plate osteotomy+vertebra osteotomy+long-segment pedicle screw fixation in the treatment of ankylosing spondylitis with kyphotic deformity.
METHODS:Thirty-six patients with ankylosing spondylitis were subjected to pedicle subtraction osteotomy and Smith-Peterson osteotomy, and then fol owed up for 3 months to 2 years.
RESULTS AND CONCLUSION:After implantation, sagittal imbalance did not occur in 36 patients, and the improvement rate of sagittal imbalance was 64%. The improvement rates of thoracolumbar kyphosis and chin-brow vertical angle were 60%and 98%, respectively. The pain relief rate was 64%, and the Oswestry Disability Index was 95%. There were no pul ed nails, broken nails and broken robs after implantation. These findings indicate that the combination of selective osteotomy technique and long-segment internal fixation can achieve stable fixation effects, prevent sagittal imbalance, and avoid the occurrence of pul ing nails, breaking nails and breaking robs caused by osteoporosis.

Objective To explore the effect of drug-psychology combined with analgesia on preoperative pain and psychological state in patients with degenerative scoliosis.Methods Thirty-two patients with degenerative scoliosis from January 2010 to December 2012 received the drug-psychology combined with analgesia before the operation,and were surveyed by the Visual Analogue Scale (VAS),Self-Rating Anxiety Scale (SAS),Medical Coping Modes Questionnaire (MCMQ) in order to analyze the pain status and psychological state before and after the analgesia.Results The scores of VAS and SAS were respectively (5.23 ± 1.74),(32.60 ± 3.71) at admission,and were (2.34 ± 1.22),(25.50 ± 3.70) after the combined analgesics,and the differences were statistically significant (t =-5.23,-4.42,respectively;P ＜0.01).The further investigation on the anxiety showed that the top three factors were respectively the worry about operation,anesthesia and prognosis,the lack of the disease-related knowledge and the fear of intensive care unit after the operation.The scores of MCMQ including face,yield,avoidance were respectively (19.52 ± 3.04),(17.16 ± 2.17),(11.98 ± 4.75) at admission,and were (23.52 ± 3.46),(14.16 ± 2.14),(8.98 ± 1.75) after the analgesics,and the differences were statistically significant (t =5.09,-4.92,-4.16,respectively ; P ＜ 0.01).Most of patients could take active coping mode.Conclusions Drug-psychology combined with analgesia can effectively alleviate pain,anxiety and negative medical coping modes induced by preoperative pain,and make patients take active coping modes,and promote the physical and psychological rehabilitation of patients with degenerative scoliosis.

Objective:To explore the current status of deep vein thrombosis (DVT) prevention and nursing in Department of Orthopedics of China hospitals, and provide a basis for hospitals and related departments to promote systematic DVT prevention and nursing management.Methods:This study was a cross-sectional study, and convenience sampling method was used. In September 2019, the self-designed Domestic Orthopedic Deep Vein Thrombosis Prevention and Nursing Questionnaire was used to investigate the members of the Orthopedic Nursing Professional Committee who signed up for the China Health Promotion Foundation Orthopedic Venous Thromboembolism (VTE) Prevention and Nursing Management Forum. The survey subject came from 125 hospitals in 29 provinces, municipalities and autonomous regions across the country. Respondents completed the electronic questionnaire survey by scanning the quick response code, and 118 valid questionnaires were finally recovered.Results:The proportion of 118 hospitals carrying out in-hospital DVT special training was 82.2% (97/118) . Among the ways for nurses to acquire knowledge, the exchanges outside the hospital, literature review, and international exchange accounted for 70.3% (83/118) , 60.2% (71/118) and 14.4% (17/118) respectively. The proportion of establishing hospital DVT risk early warning information system was 57.6% (68/118) . The hospital-level professional group formulated a complete DVT prevention and nursing system process accounting for 44.1% (52/118) , and the department-level professional group formulated a complete DVT prevention and nursing system process accounting for 36.4% (43/118) . In the comprehensive evaluation of DVT prevention and nursing management, 65.3% (77/118) of hospitals rated it as excellent, and 34.7% (41/118) of hospitals rated it as fair and lacking.Conclusions:The Department of Orthopedics of China hospitals attaches great importance to DVT prevention, but in the construction of DVT prevention and nursing management system for orthopedic patients, the popularization of DVT risk early warning information system, the application of DVT preventive equipment measures, the improvement of DVT prevention and nursing related systems, and the implementation of professional management specifications needs to be further strengthened.

【Objective】 To explore the safety and efficacy of a novel endoscopic two-wire guided dilation in the creation of channels in percutaneous nephrolithotomy (PCNL). 【Methods】 Clinical records of 180 patients undergoing PCNL during Oct.2020 and Oct.2022 were retrospectively analyzed. The patients were divided into three groups, 60 in AMD group (fascial amplatz dilation), 60 in OSD group (one shot dilation) and 60 in END group (endoscopic dilation). Time to establish channels, operating time, failure of access, stone clearance rate, drop in hemoglobin, embolization rate, fever rate, blood transfusion rate and postoperative hospitalization were compared among the three groups. 【Results】 There were no significant differences in the general data among the three groups (P>0.05). Compared with AMD and OSD groups, END group needed significantly reduced time to establish the first channel [(5.6±0.8) min vs. (4.9±1.4) min vs. (4.2±0.5) min, (P<0.05)] . Compared with OSD group, END and AMD groups had significantly more hemoglobin drop [(14.0±17.6) g/L vs. (19.4±12.6) g/L vs. (10.2±6.8) g/L, (P<0.05)] . There were no significant differences in terms of failure of establishing channels, operating time, stone clearance rate, embolization rate, fever rate, blood transfusion rate and postoperative hospitality. Four patients needed selective renal artery embolization (1 case in AMD group and 3 in OSD group). No serious complications such as organ injuries, septic shock or death occurred. 【Conclusion】 Endoscopic two-wire guided dilation is simple, with few complications and good application value.