Objective To summarize the nursing cooperation in 28 cases of placenta praevia or dangerous cesarean section delivery in which acute normovolemic hemodilution ( ANH ) in combination with autologous blood transfusion were applied. Methods Before the surgery, autologous blood were collected from 28 cases with smooth anesthesia of ASA classⅠ-Ⅱparturients post general anesthesia, accompanying rapid intravenous infusion of the equivalent colloid solution. The vital sighs and fetal heart of parturients were comprehensive monitored during the collection procedure. When the blood loss reached to 400-600 ml or the hemoglobin ( Hb ) were below 80 g/L during the late phase of surgery, autologous blood was transfused toparturients. Results All 28 cases safely wentthrough the operative period with the mean operation time (69. 00 ±18.81) min, mean blood loss (988.00 ±382.65) ml and mean autologous blood transfusion (387.00 ± 122. 07) ml, respectively. Meanwhile, there were no adverse reactions of parturients during the process of collection and transfusion of autologous blood. Furthermore, the mean 1, 5 min Apgar score of newborn children ranged from 7 to 10. Conclusions ANH in combination with autologous blood transfusion,serving as an effective measure for blood conservation,plays a important role in dealing with postpartum hemorrhage and was not harmful to parturients or fetuses. ANH in combination with autologous blood transfusion, as a safe and efficient blood transfusion mode,attenuated the current shortage of blood for clinical use to a great extent.

Objective To explore the methods and effects of pressure ulcer prevention and management for patients receiving ankylosing spondylitis surgery. Methods Totally 51 patients who received ankylosing spondylitis surgery in our hospital from January 2015 to May 2016 were selected by purposive sampling method, excluding those who had skin damage before operation. Patients′ preoperative and postoperative skin conditions were evaluated by Waterlow pressure ulcer risk assessment scale,and corresponding prevention measures were taken based on the risk factors of pressure ulcer that they had,including targeted interview,use of TG-A arched frame,intensive wake-up tests before operation,the reduction of pressure on pressed parts with protective pad such as gel pad and foam materials,close coordination and synchronized movement between doctors and nurses in reposition during operation,and condition evaluation of pressed skin according to the staging criteria recommended by the National Pressure Ulcer Advisory Panel of America,closer attention and pressure prevention after operation.Results Among 51 patients,35 had high risk of pressure ulcer (15-19 points), and 16 cases had extremely high risk (≥20 points). After pressure ulcer prevention and management,there was only one case of stage II pressure ulcer whose preoperative pressure ulcer assessment was 25,and belongs to extremely high risk,and the incidence of pressure ulcer was 1.96%.Conclusions Ankylosing spondylitis patients have high risk of pressure ulcer during the perioperative period,and targeted preventative measures can help to reduce the incidence of intraoperative pressure ulcer effectively.

Objective To investigate the impacts of graphic health education on postoperative functional recovery of elderly with intertrochanteric fractures. Methods A total of 72 elderly patients, who admitted to hospital with intertrochanteric fractures from March 2012 to March 2013, were divided into observation group and control group by random number table;health education for patients and their families in the observation group were based on graphics cards done by nurse, while patients and their families of the control group underwent conventional health education. Two groups were compared in operative time, healing time, Harris score and other indexes, health education awareness score and satisfaction rate. Results The healing time of observation group were (14.1±0.9) w and (14.5±1.1) w in the control group (t=1.6886,P>0.05), while Harris score were (13. 2 ± 3. 2) point in the observation group higher than (9. 6 ± 2. 8) point in the control group (t=5. 079 9,P<0. 01). Health education awareness score of observation group were (88. 7 ± 10. 8) point higher than (73. 2 ± 11. 2) point of the control group (t=5. 977 3,P<0. 01);the satisfaction with nursing work was 94. 4% in the observation group comparing with 77. 7% in the control group (P<0. 05). Conclusions Graphics health education can improve the awareness of intertrochanteric fractures and patient satisfaction among elderly, and is conducive to functional recovery, which is worthy of clinical application.

As a kind of skills clinical medical students must master, the basic teaching of operative surgery is relatively backward in teaching mode and means, thus negatively affecting the teaching effect. The virtual reality is applied to the basic teaching of operative surgery, and the pre-designed course contents are presented in a situational way, so that students can experience the immersive learning style. It changes the classroom roles, gives full play to the advantages of virtual reality, and makes up the disadvantage of traditional education mode, finally improving the training effect.

Objective To observe the effects of radial artery pressure combined with somatosensory evoked potential monitoring on decreasing the incidence of brachial plexus paralysis in ankylosing spondylitis (AS)patients with kyphosis of thoracic and lumbar vertebra who were corrected surgically by pedicle subtraction osteotomy (PSO).Methods A total of 36 AS patients with kyphosis of thoracic and lumbar vertebra undergoing the surgery of PSO were selected from January 201 4 to December 201 4.During surgery,all patients were applied with artery pressure combined with somatosensory evoked potential monitoring for protecting brachial plexus.Results Positive monitoring indicators occurred in 2 patients during surgery.And then,the monitoring indicators returned to normal by adjusting body position on time;they were not with the symptom of brachial plexus paralysis after surgery.However,positive monitoring indicators occurred in 1 patient and didn′t return to normal by repeatedly adjusting body position.Thus,the patient was found with the symptom of mild brachial plexus paralysis after surgery and returned to normal at 1 week after treatment.There were no neural complications caused by operation during surgery.Conclusions Radial artery pressure combined with somatosensory evoked potential monitoring can indicate the change of compression degree of the brachial plexus in AS patients with kyphosis of thoracic and lumbar vertebra undergoing the surgery of PSO,and it can effectively decrease the incidence of brachial plexus paralysis by appropriate treatment.