Objective:To explore the effect of therapeutic communication on infusion safety, disease uncertainty, coping styles, anxiety and depression in patients with emergency infusion.Methods:A total of 126 patients treated with infusion patients in emergency department in Jiangsu Provincial People's Hospital, the First Affiliated Hospital of Nanjing Medical University from July 2019 to December 2019 were selected and divided into two groups by random digits table method with 63 cases in each group. Patients in the control group received routine nursing, and patients in the intervention group received therapeutic communication nursing intervention on this basis. The incidence of adverse events of infusion during the intervention of the two groups of patients was observed. The disease uncertainty, coping styles, anxiety and depression were evaluated by Mishel's Uncertainty in Illness Scale (MUIS), Medical Coping Mode Questionnaire (MCMQ), Self-rating Anxiety Scale (SAS) and Self-rating Depressive Scale (SDS) before and after intervention.Results:The final collection of 109 patients with complete questionnaire, the recovery rate was 86.51% (109/126), including 55 cases in the intervention group, 54 cases in the control group. The incidence of adverse events of infusion was 16.36%(9/55) in the intervention group and 29.63%(16/54) in the control group, and there was significant difference( χ2 value was 5.057, P<0.05). There was no significant difference in the score of MUIS, MCMQ, SAS, SDS before the intervention between the two groups ( P>0.05). After the intervention, the uncertainty, unpredictability, lack of information and complexity dimension of the intervention group patients' MUIS scores were respectively (17.76 ± 2.49), (12.03 ± 2.51), (11.82 ± 2.12), (11.74 ± 2.24), which were lower than those in the control group (24.72 ± 2.94), (16.31 ± 2.27), (16.13 ± 2.51), (15.39 ± 2.31), the differences were significant( t values were -13.346- -8.375, P<0.05). The confront score of the intervention group patients' MCMQ was (19.13 ± 2.62) higher than that in the control group(13.79 ± 1.96), the avoidance and yield scores were respectively (8.71 ± 1.34), (9.81 ± 1.17), which were lower than those in the control group (14.57 ± 1.93), (15.12 ± 1.86), the differences were significant( t values were 12.031, -18.441, -17.875, P<0.05). The scores of SAS and SDS in the intervention group were (29.43 ± 3.62), (27.67 ± 3.11) respectively, which were lower than those in the control group (37.44 ± 5.31), (40.12 ± 4.92), the differences were significant( t values were -9.216, -15.821, P<0.05). Conclusions:Therapeutic communication can reduce the risk of emergency infusion, reduce the uncertainty of patients to the disease, improve patients' countermeasures to the disease, relieve patients' anxiety and depression, and improve the nursing quality of emergency infusion patients.

Objective:To discuss the effect of improved supine position on the prevention of pressure injuries of emergency patients under observation and their comfort levels.Methods:A total of 114 patients in our Emergency Observation Ward were randomly divided into the intervention group and control group, 57 patients in each. Patients in the control group were treated with routine supine position and pressure injury prevention nursing; while patients in the intervention group were treated with improved supine position nursing intervention. Then, the incidence of pressure injury, its risk score and its comfort evaluation were compared between patients under observation in the two groups.Results:The incidence of pressure injury of the intervention group was obviously lower than that in the control group ( Z value was -2.426, P<0.05). The scores of sensation, humidity, activity, friction and shear force of patients in the intervention group were 3.36 ± 0.59, 2.92 ± 0.47, 3.21 ± 0.52 and 2.61 ± 0.29 respectively, which were significantly higher than those in the control group, specifically 2.87 ± 0.51, 2.24 ± 0.38, 2.76 ± 0.44 and 2.04 ± 0.32. The difference was statistically significant ( t value was 4.74-9.96, P<0.01). In addition, the scores of the physiological and psychological comfort level of patients in the prevention group were 15.41±2.49 and 27.26 ± 3.42 respectively, which were significantly higher than 11.01±1.97 and 22.14± 3.23 in the control group. The difference was statistically significant ( t value was 10.46, 8.21, P<0.05). Conclusions:The improved supine position nursing method can effectively lower the occurrence of pressure injury in emergency patients under observation and enhance patients’ comfort degree. Therefore, it is applicable to emergency patients under observation.

10.3969/j.issn.2095-4344.2013.26.023

Objective To compare the curative effect of percutaneous endoscopic lumbar discectomy (PELD) and microendoscopic discectomy (MED) in lumbar disc herniation.Methods A literature search was performed in PubMed, Web of Science, Embase, Wanfang, CNKI. Two authors reviewed all articles individually. The methodological quality of RCTs was assessed by the Cochrane risk of bias tool, and the quality of retrospective studies was evaluated by the modified Newcastle-Ottawa scale. The data was extracted by the Review Manager 5.30.Results A total of 19 articles were brought into this Meta-analysis. The outcomes were divided into primary outcomes and secondary outcomes. Excerpt for the short-term VAS score was lower in PELD group (P = 0.010), other index, including long-term VAS score (P = 0.120), ODI score (P = 0.260), complication (P = 0.100) and recurrence (P = 0.100), didn't had significant difference in two groups. The blood loss (P = 0.000), hospital stay (P = 0.000) and the length of incision (P = 0.000) were all superiority in PELD group. Whereas the operative time was shorter in MED group (P = 0.001).Conclusion PELD was a more minimally invasive and secure technique in lumbar disc herniation.

Objective:To explore the effects of different ankle pump exercises on femoral vein hemodynamics and lower limb fatigue in healthy adults.Methods:From January to June 2021, 30 healthy adults who met the enrollment conditions in the First Affiliated Hospital with Nanjing Medical University were selected by convenient sampling as the research subject. Using a prospective self-contrast method, the effects of resting state, ankle dorsiflexion and plantar flexion on femoral vein blood flow in lower limbs were investigated by Doppler ultrasound. Then the subjects received two kinds of ankle exercises, the traditional method was dorsiflexion 10 s relaxation 5 s, plantar flexion 10 s relaxation 5 s; the modified method was dorsiflexion 1 s relaxation 1 s, plantar flexion 1 s relaxation 1 s. The hemodynamics of subjects were measured immediately after 5 min of exercise, 5 min of rest after exercise and 10 min of rest after exercise. And the subjective sensory fatigue scores of the subjects for different exercise modes were evaluated when the exercise lasts for 1, 3 and 5 minutes.Results:Compared with the rest state, the peak velocity, average flow velocity and blood flow of femoral vein in ankle dorsiflexion and plantar flexion were increased, and the differences were statistically significant ( P<0.01) . Compared with plantar flexion, the peak velocity, average flow velocity and blood flow of femoral vein during ankle dorsiflexion were statistically increased ( P<0.05) . There was no statistical difference in peak velocity and average velocity of femoral vein blood flow between the two ankle pump exercises at different time points ( P>0.05) . There was no statistical difference in the scores of subjective sensory fatigue after 1 and 3 min of two kinds of exercise ( P>0.05) , but the scores of subjective sensory fatigue after 5 min of traditional exercise were higher than those of modified exercise with a statistical difference ( P<0.05) . Conclusions:The effect time of ankle dorsiflexion and plantar flexion on femoral vein blood flow velocity in healthy adults is 1 to 2 seconds. The rhythms of dorsiflexion and plantar flexion of ankle pump exercise in unit time are suggested to be 1 s, which is simpler and easier than the traditional exercise. We should instruct the patient to increase the number of ankle pump exercises every day for 5 minutes or within the patient's tolerance.

Objective: To evaluate the clinical efficacy of the modified Stoppa approach in the surgical treatment of pelvic fractures of Tile type C combined with acetabular both-column fractures. Methods: Between April 2014 and April 2017, a total of 14 patients were treated by open reduction and internal fixation (ORIF) through the modified Stoppa approach at Department of Orthopaedics, Foshan Gaoming Hospital for pelvic fractures of Tile type C combined with acetabular both-column fractures. They were 10 men and 4 women, with an average age of 36.4 years (from 23 to 57 years). The modified Stoppa approach was used exclusively in 4 cases, in combination with the iliac fossa approach in 3 ones, in combination with the Kocher-Langenbeck approach in 4 ones and in combination with the Kocher-Langenbeck and iliac fossa approaches in 3 ones. In all the patients, the pelvic reconstructive plate and screws and lag screws were used. The operation time, intraoperative bleeding volume, postoperative fracture reduction, fracture union time, efficacy and complications were recorded. Results: The operation time averaged 170 min (from 110 to 330 min) and the intraoperative bleeding 420 mL (from 240 to 1 100 mL). There were no operative complications. By the Matta evaluation, the postoperative reduction was rated as excellent in the 14 pelvic fractures and 9 acetabular both-column fractures and as good in 5 acetabular both-column fractures. Of this series, 13 patients were followed up for an average of 19 months (from 12 to 29 months) and one was lost to the follow-up. The fractures got united after an average time of 3.4 months (from 2.7 to 4.6 months). Screw loosening was observed in one case and mild limitation to hip flexion in one. Follow-ups found no lateral ventral syndrome or femoral head necrosis. Their Harris hip scores at the last follow-up ranged from 70 to 94 points, averaging 84 points. The function of the affected hip was excellent in 6 cases, good in 5 and fair in 2. Conclusion The modified Stoppa approach may be used exclusively or in combination with other approaches to treat effectively the pelvic fractures of Tile type C combined with acetabular both-column fractures, leading to good short-term clinical outcomes.