Objective? To explore the application value of case management mode combined with enhanced recovery after surgery (ERAS) in the perioperative period of patients with diode laser enucleation of prostate. Methods? A total of 106 patients with benign prostatic hyperplasia who were treated in the Third Department of Urology of Hu'nan Provincial People's Hospital from January 2017 to June 2018 were selected. These patients were divided into observation and control groups according to the odd and even numbers of the admission order, with 53 cases in each group. The two groups were treated by diode laser enucleation of prostate by continuous epidural anesthesia. The observation group received perioperative management according to the case management mode combined with ERAS program. The control group received traditional perioperative management. The first time of anal exhaust, the time of ambulation, the length of bladder irrigation and indwelling catheter, the complications, hospitalization days after surgery, the total cost during hospitalization, the pain score on the first day after operation, the International Prostate Symptom Score (IPSS) and the maximal urinary flow-rate (Qmax) on the second day after catheter removal were compared between two groups. Results? In the observation group, the first time of anal exhaust, the first time of ambulation, the time of bladder irrigation, the duration of indwelling catheter, the duration of hospitalization, the fee of hospitalization were (19.60±2.98) h, (1.63±0.57) d, (1.58±0.50) d, (3.44±0.80) d, (4.92±1.19) d and (10.94±4.5) thousand yuan respectively, which were lower than those of the control group [(27.75±4.67) h, (3.57±0.99) d, (3.53±0.83) d, (5.06±0.99) d, (7.70±1.81) d and (27.8±4.5) thousand yuan], and the differences were statistically significant (P＜ 0.01). The incidence of complications of the observation group was 7.55%, which was lower than that of the control group 22.64% (P＜ 0.05). The pain score on the first day after operation of the observation group was lower than that of the control group, and the difference was statistically significant (P＜ 0.05). However, there were no statistical significance in the difference in IPSS and Qmax on the second day after catheter removal between the two groups (P＞ 0.05). Conclusions? The case management mode combined with ERAS concept can accelerate postoperative rehabilitation of patients with diode laser enucleation of prostate, reduce postoperative complications, shorten hospitalization day and reduce hospitalization costs.

Objective To compare and analyze the relationship between geometric parameters of the needle of different insulin pens and their puncture force, flow rate, and pressing force. Methods The human skin tissue model and needle model were established, and the finite element simulation analysis of needle puncture was performed. Using a test platform, 25 kinds of needles with different geometric parameters were tested for the puncture force, pushing pressure, flow rate and other parameters. The influence of geometric parameters on the performance of the needles were analyzed. Results The puncture force of the needle was closely related to its section design. Compared with the three-section needle, the five-section needle increases the secondary inclination angle and the condyle angle, increases the contact area between the needle and the tissue, and make the change of the contact angle more smoothly, which reduce the needle penetration force. The smaller the outer diameter of the needle, the smaller the penetrating power. The larger the inner diameter of the needle, the greater the fluid flow rate, the smaller the pushing pressure, and the higher the injection accuracy. Conclusions Five-section, ultra-thin-walled or ultra-thin-walled needles have more excellent performance. On the basis of ensuring the strength of the needle, the needle's geometry can be optimized to reduce the puncture force. The results of this study can provide theoretical basis and experimental basis for the design of needles for insulin pens.

Objective:To conduct theoretical analysis and experimental research on peripherally inserted venous catheters, establish theoretical models of interaction between different materials catheters and simulated skin tissues, and test different catheters at the same time to provide theoretical basis and experimental basis for the optimization design.Methods:According to the mechanical properties of the catheter at 25 ℃ and 37 ℃, a finite element model of the catheter and simulate skin tissue was established. The relationship between catheter folds and material and structure during puncture was analyzed, and the stiffness, radiographic properties, etc. were tested experimentally.Results:The performance of the catheter at different temperatures is closely related to its material. The wrinkle situation of the catheter is related to the catheter material and the inclination of the wedge surface. The elastic modulus of the polyurethane (PU) catheter is about 500 MPa and 250 MPa, respectively at room temperature (25 ℃) and body temperature (37 ℃), which meets the clinical needs of high rigidity during puncture and soft material during indwelling. When the catheter structure is the same, the PU catheter is less prone to wrinkles than the fluorinated ethylene propylene copolymer (FEP) catheter. When the catheter material is the same, the smaller the inclination of the wedge surface, the less likely the catheter to wrinkle.Conclusions:Appropriately reducing the inclination of the wedge-shaped surface of the needle of peripherally inserted venous catheters can improve the success rate of puncture. The PU catheters have good mechanical properties, they are not prone to wrinkles during puncture, and their stiffness can be reduced at body temperature, which can not only increase the success rate of puncture, but also reduce the occurrence of complications. Therefore, PU catheters have a better clinical application prospect.

Objective To explore the effects of nurse-patient horizontal communication on medical compliance behavior and postoperative complications in patients with benign prostatic hyperplasia ( BPH ) . Methods A total of 218 patients with BPH were recruited in the department of urology of Hunan Provincial People′s Hospital from March 2014 to December 2015. They were divided into control group ( n=109, routine nursing) and experimental group ( n=109, routine nursing+personalized horizontal communication model ) according to the order of admission. After intervention, patient compliance, the length of hospital stay, postoperative complications and patient satisfaction were evaluated between two groups. Results The patient compliance behavior on medication, reasonable diet and relaxation, giving up smoking and drinking of patients in experimental group were better than those in control group. Besides, the length of hospital stay and the number of patients with gross hematuria, enuresis or lower urinary tract symptoms in experimental group were less than those in control group. Moreover, the patient satisfaction of experimental group was better than that of control group. There were significant differences in those aspects between two groups ( P < 0. 05 ) . Conclusions The nurse-patient horizontal communication will be propitious to improve the patient compliance, reduce the length of hospital stay, decrease the incidence of complications and increase the patient satisfaction.

Objective? To explore the application value of individualized full-term management model in the management of patients with hermaphroditism. Methods? From January 2015 to June 2018, a total of five hermaphroditism patients were treated in Department of Urology Surgery at the First Affiliated Hospital of Hu'nan Normal University. The perioperative and post-discharge transitional care were performed by the individualized full-term management model. Results? Among five patients, the surgeries were smooth with primary healing wounds. After discharge, the treatment compliance and social adaptability were all good. Conclusions? The application of individualized full-term management model for perioperative and post-discharge transitional care among hermaphroditism patients helps to promote the postoperative rehabilitation of patients,helps patients transit to social smoothly and improve patients' experience to seek medical advice.

Objective:To explore the effect of whole-process management mode based on "Internet + nursing service" in the management of children with concealed penis.Methods:This study adopted a quasi-experimental research method. A total of 383 children with concealed penis who were hospitalized in the Third Department of Urology of Hunan Provincial People′s Hospital from January 2018 to August 2021 were convenient selected. According to the sequence of admission, 195 children admitted from January 2018 to May 2020 were set as the control group, and 188 children admitted from June 2020 to August 2021 were set as the observation group. The control group was received conventional treatment and nursing, but the observation group was received whole-process management mode based on "Internet + nursing service". The length of hospitalization, incidence of complications after discharge, anxiety of the children′s parents and satisfaction of the doctors, the specialist & nurse sharing and the children′s parents were compared between the two groups.Results:Finally, 186 and 193 children were included in the observation group and the control group, respectively After the intervention, in the observation group, the length of hospitalization, anxiety score of the children′s parents, difference of anxiety score of the children′s parents, satisfaction content of the doctors, satisfaction effect of the doctors, satisfaction content of the specialist & nurse sharing, satisfaction effect of the specialist & nurse sharing, satisfaction content of the children′s parents and satisfaction effect of the children′s parents were (4.30 ± 1.35) d, (35.08 ± 3.17) points, (19.14 ± 4.35) points,(4.57 ± 0.54) points, (4.71 ± 0.49) points, (4.75 ± 0.50) points, (5.00 ± 0.00) points, (4.60 ± 0.49) points, (4.65 ± 0.49) points; in the control group, the scores were (5.50 ± 1.41) d, (44.79 ± 3.30) points, (9.22 ± 3.67) points, (3.71 ± 0.49) points, (4.00 ± 0.58) points, (3.50 ± 0.58) points, (3.25 ± 0.50) points, (3.54 ± 0.59) points, (3.64 ± 0.67) points. The differences between the two groups were statistically significant ( t values were -23.94-29.19, all P<0.05). The complication rates of the observation group and the control group were not statistically significant ( χ2=0.64, P>0.05). Conclusions:The whole-process management mode based on "Internet + nursing service" is beneficial to shorten the length of hospitalization, relieve the degree to anxiety of the children′s parents, improve the satisfaction of the doctors, the specialist & nurse sharing and the children′s parents, and accelerate the rehabilitation of children, which is worthy of clinical promotion.

Objective To investigate the current situation of standardized training and its influencing factors in the introduction of massive open online course (MOOC) teaching methods to newly recruited nurses. Methods From July to October 2017, a questionnaire survey was conducted on 176 nurses in a ClassⅢGrade A hospital in Hu'nan Province. The survey contents included general information, status of new nurses' participation of the standardization training of MOOC and the satisfaction of it. Results The total score of the trainee nurses attending the standardized training of MOOC was (68.85±9.65), and score of satisfaction was (64.42±9.60). The result of multivariate analysis indicated that nurses' education degree, the length of work and the educator's professional title were the main influencing factors of new nurses' satisfaction with MOOC standardization training (P< 0.05). Conclusions The current status and satisfaction of the newly enrolled nurses in MOOC training are at a moderate level. It is suggested that based on the influencing factors, hospitals should perfect the MOOC platform, adjust new nurses scheduling system, strengthen the construction of teachers team, so that the new nurses can integrate more quickly into clinical practice.

Objective:To explore the application effect of standardized management mode of the whole course of disease led by nurses in patients of percutaneous nephrolithotomy (PCNL) .Methods:A total of 100 PCNL patients in the Department of Urology Surgery of Hunan Provincial People's Hospital, from July 2019 to July 2020, were selected as the research subjects, and divided into observation group and control group according to admission order, with 50 cases in each group. Both groups accepted routine treatment and nursing, while the observation group also received the standardized management mode of the whole course of disease. The duration of preoperative preparation, length of hospitalization, hospitalization cost, postoperative complications and the rate of unplanned return visit within 1 month after discharge were compared between the two groups.Results:The duration of preoperative preparation and the length of hospitalization of the observation group were both less than the those of the control group, and the differences were statistically significant ( P<0.05) . The hospitalization cost of the observation group was less than that of the control group, with statistical significance ( P<0.05) . The postoperative complications and the rate of unplanned return visit within 1 month after discharge of the observation group were both lower than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The standardized management mode of the whole course of disease led by nurses is beneficial to shorten the waiting time and total hospitalization time of PCNL patients, reduce hospitalization expenses, reduce complications and unplanned return visit, which is worthy of clinical promotion.