Objective:To investigate the anti-inflammatory effect and safety of tranexamic acid in the perioperative period of total knee arthroplasty.Methods:Eighty patients who underwent primary unilateral total knee arthroplasty because of knee osteoarthritis in Anqing Hospital of Anhui Medical University from October 2018 to March 2020 were included in this study. They were divided into an observation group and a control group ( n = 40/group) according to whether they received tranexamic acid treatment. In the observation group, 1 g tranexamic acid was intravenously administered at 10 minutes before releasing tourniquet and once every 3 hours starting at 24 hours after surgery. In the control group, 100 mL 0.9% sodium chloride injection was identically administered. Before surgery, immediately after surgery, and 1, 2 and 3 days after surgery, interleukin-6 level, erythrocyte sedimentation rate and C-reactive protein level in the venous blood were compared between the observation and control groups. Coagulation function and lower extremity deep venous thrombosis in the two groups were monitored. Postoperative pain, nausea, vomiting and muscle strength were compared between the two groups. Results:There were no significant differences in age, gender, body mass index and Hospital for Special Surgery knee score between the two groups (all P > 0.05). Univariate analysis of variance revealed that there were significant differences in interleukin-6 level ( t1 = 9.364, t2 = 11.027, t3 = 11.068), erythrocyte sedimentation rate ( t1 = 20.94, t2 = 18.898, t3 = 22.797) and C-reactive protein level ( t1 = 14.079, t2 = 12.099, t3 = 23.416) between the two groups at 1, 2 and 3 days after surgery (all P < 0.05). Regression analysis revealed that the maximum differences in erythrocyte sedimentation rate ( β = 0.217, P = 0.038), interleukin-6 ( β = 0.143, P = 0.025) and C-reactive protein ( β = 0.032, P = 0.010) between before and after total knee arthroplasty in the observation group were significantly lower compared with the control group ( β > 0, P < 0.10). Moreover, the differences in erythrocyte sedimentation rate, interleukin-6 and C-reactive protein at 3 days after surgery were significantly lower compared with at the other time points studied. Before and after surgery, there was no significant difference in coagulation function between the two groups (both P > 0.05). Lower extremity deep venous thrombosis occurred in neither groups. The recovery of postoperative pain, nausea, vomiting, and muscle strength in the observation group was significantly superior to that in the control group (all P < 0.05). Conclusion:Application of tranexamic acid in primary unilateral total knee arthroplasty can effectively attenuate perioperative inflammatory reaction, reduce postoperative adverse reactions and promote functional recovery, which deserves clinical application.

Objective:To evaluate the application method and effect of standardized scenario simulation teaching based on Kirkpatrick model in vocational protection education for nursing students.Methods:A historical controlled trial study was designed. Practical nursing students enrolled in 2018-2019 and 2017-2018 were selected into the experimental group ( n=203) and control group ( n=196), respectively. The experimental group adopted standardized scenario simulation teaching in the prevention and control education of needlestick injuries, and the control group adopted traditional classroom lecture. Using the Kirkpatrick model, the teaching effect of needlestick injuries protection for nursing students were compared between the 2 groups from such 4 levels as in reaction level, learning level, behavior level and results level. Results:There was no significant difference in the baseline data between the two groups in terms of age, gender, educational background and test scores of nursing professional knowledge as compared to that before practice. In reaction level: the nursing students' satisfaction of experimental group in teaching methods ( t=25.149, P<0.001) and teaching environment ( t=12.827, P<0.001) are higher than that of the control group, with statistical significance. In learning level: the test scores of needlestick injury knowledge in experimental group were significantly higher than those in control group ( t=8.221, P<0.001). In behavior level: the level of needlestick injury protection behavior in the experimental group was significantly higher than that in the control group ( t=9.250, P<0.001), and the knowledge conversion rate in the experimental group was higher than that in the control group ( t=6.054, P<0.001). In results level: the needlestick injuries incidence of experimental group was significantly lower than that of the control group ( χ2=15.815, P<0.001), the reported rate of needlestick injuries of experimental group was significantly lower than that of the control group ( χ2=14.185, P<0.001). Conclusion:The implementation of standardized scenario simulation teaching can effectively improve the effectiveness of vocational protection learning and reduce the incidence of needlestick injuries.