Objective:To construct a perioperative venous thrombosis prevention program for patients with spinal surgery based on evidence-based nursing, and to discuss its application effect.Methods:Using the convenient sampling method, a total of 90 patients with spinal surgery who were admitted to Jinhua People's Hospital from June 2019 to June 2020 were selected as the control group and received routine nursing management. A total of 90 patients with spinal surgery who were admitted to Jinhua People's Hospital from July 2020 to July 2021 were selected as the observation group, and they were given a venous thrombosis prevention scheme based on evidence-based nursing. The prothrombin time, thrombin time, activated partial thromboplastin time, fibrinogen and D-dimer levels, blood flow velocity of common femoral vein, popliteal vein, iliac vein and occurrence of thrombosis were compared between the two groups.Results:The prothrombin time, thrombin time, fibrinogen and D-dimer levels in the two groups had interaction, and the differences were statistically significant ( Finteraction=6.079, 8.735, 6.918, 8.657; all P<0.01) . Postoperative prothrombin time, thrombin time and activated partial thromboplastin time all showed a trend of decreasing first and then increasing and the levels of fibrinogen and D-dimer showed a trend of increasing first and then decreasing, and the differences were statistically significant ( P<0.05) . Regardless of the time factor, postoperative prothrombin time, thrombin time, and activated partial thromboplastin time in the observation group were longer than those in the control group, and the levels of fibrinogen and D-dimer were lower than those in the control group, and the differences were statistically significant ( P<0.05) . The blood flow velocity of common femoral vein, popliteal vein, and iliac vein in the two groups were interacted, and the difference was statistically significant ( Finteraction=6.257, 3.281, 7.697; all P<0.05) . After operation, the blood flow velocity of common femoral vein, popliteal vein and iliac vein all showed a trend of first decreasing and then increasing, and the differences were statistically significant ( P<0.05) . Regardless of the time factor, the postoperative blood flow rates of the common femoral vein, popliteal vein and iliac vein in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The incidence of venous thromboembolism in the observation group was 1.11%, which was lower than 6.67% in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The perioperative venous thrombosis prevention and management plan based on evidence-based nursing can provide individualized nursing intervention for spinal surgery patients according to different thrombosis risks, which can improve patients' coagulation and lower extremity venous function and effectively reduce the risk of thrombosis.

Objective:To construct a perioperative venous thrombosis prevention program for patients with spinal surgery based on evidence-based nursing, and to discuss its application effect.Methods:Using the convenient sampling method, a total of 90 patients with spinal surgery who were admitted to Jinhua People's Hospital from June 2019 to June 2020 were selected as the control group and received routine nursing management. A total of 90 patients with spinal surgery who were admitted to Jinhua People's Hospital from July 2020 to July 2021 were selected as the observation group, and they were given a venous thrombosis prevention scheme based on evidence-based nursing. The prothrombin time, thrombin time, activated partial thromboplastin time, fibrinogen and D-dimer levels, blood flow velocity of common femoral vein, popliteal vein, iliac vein and occurrence of thrombosis were compared between the two groups.Results:The prothrombin time, thrombin time, fibrinogen and D-dimer levels in the two groups had interaction, and the differences were statistically significant ( Finteraction=6.079, 8.735, 6.918, 8.657; all P<0.01) . Postoperative prothrombin time, thrombin time and activated partial thromboplastin time all showed a trend of decreasing first and then increasing and the levels of fibrinogen and D-dimer showed a trend of increasing first and then decreasing, and the differences were statistically significant ( P<0.05) . Regardless of the time factor, postoperative prothrombin time, thrombin time, and activated partial thromboplastin time in the observation group were longer than those in the control group, and the levels of fibrinogen and D-dimer were lower than those in the control group, and the differences were statistically significant ( P<0.05) . The blood flow velocity of common femoral vein, popliteal vein, and iliac vein in the two groups were interacted, and the difference was statistically significant ( Finteraction=6.257, 3.281, 7.697; all P<0.05) . After operation, the blood flow velocity of common femoral vein, popliteal vein and iliac vein all showed a trend of first decreasing and then increasing, and the differences were statistically significant ( P<0.05) . Regardless of the time factor, the postoperative blood flow rates of the common femoral vein, popliteal vein and iliac vein in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The incidence of venous thromboembolism in the observation group was 1.11%, which was lower than 6.67% in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The perioperative venous thrombosis prevention and management plan based on evidence-based nursing can provide individualized nursing intervention for spinal surgery patients according to different thrombosis risks, which can improve patients' coagulation and lower extremity venous function and effectively reduce the risk of thrombosis.

Objective:The aim of this study was to compare the efficacy and safety of iguratimod (IGU) or leflnomide (LEF) in combination with methotrexate (MTX) in patients with active rheumatoid arthritis (RA).Methods:This was a multicenter, randomized, double-blinded, double dummy and controlled clinical trial. Patients with moderate or high active RA were randomized in a 1∶1 ratio to receive IGU+MTX (Group A) or LEF+MTX (Group B) treatment. The efficacy and safety were assessed at week 12, 24 and 52, respectively. The primary endpoint was the American Colleague of Rheumatology 20 (ACR20) response rates at the 52th week. Pearson chi square test and two-way Analysis of Variance (ANOVA) were used to compare the improve- ment of ACR20 and DAS28 at 52 weeks. Pearson chi square test or Fisher exact probability test were used to compare the ACR 20 and ACR70 rate between the two groups after treatment. The measurement data of the two groups were compared by independent sample t-test or nonparametric test. Results:A total of 240 RA patients were enrolled in the present study. As a result, 84.1% and 81.0% of patients achieved ACR20 criteria at the 52th week in Group A and Group B, respectively ( χ2=0.35, P=0.56). And the ACR50/70 response rates, disease activity score 28 (DAS28), simplified disease activity index (SDAI) and the absolute decrease of DAS28 from baseline were not statistically different between the two groups at week 12, 24 and 52. The rates of adverse events were lower in Group A than those in Group B (60.0% vs 79.0%, P<0.01). The elevations of glutamic pyruvic transaminase/glutamic oxalacetic transaminase levels, concomitant use of hepatinica and white blood cell decrease were more common in Group B ( P<0.05). Conclusion:IGU in combination with MTX is an efficacious and safe treatment regimen, which is comparable in efficacy in control active RA but superior in safety to LEF combined with MTX.

Objective:To construct a competency evaluation indicator system for infection prevention and control nurses in Operating Rooms (hereinafter referred to as "IPC") and provide an objective basis for the management of IPC nurses.Methods:From June to November 2022, an initial competency evaluation indicator system for IPC nurses was developed through literature review and semi-structured interviews. The Delphi method was employed to consult 20 experts from 11 provinces and municipalities across the country. Analytical Hierarchy Process (AHP) and mean distribution method were applied to quantify and determine the weight of each level of indicators within the system.Results:Nineteen experts were finally included, with two rounds of questionnaire recovery rates of 95.00% (19/20) and 100.00% (19/19), respectively. The authority coefficients of the experts were 0.858 and 0.861, familiarity coefficients were 0.850 and 0.853, and coefficients of judgment basis were 0.865 and 0.868, respectively. The Kendall's W coefficient of concordance for the two rounds of inquiries were 0.139 and 0.202 ( P<0.05), respectively. The final IPC nurse competency evaluation indicator system included six primary indicators, 22 secondary indicators, and 66 tertiary indicators. Conclusions:The constructed IPC nurse competency evaluation indicator system is scientific, reasonable, objective, and comprehensive, providing a valuable reference for the capability training, assessment, entry standards, and qualification certification of IPC nurses.