Objective To explore the effect of different temperature of the forced- air warming system on the prevention of hypothermia during laparotomy of infants. Methods A total of 60 infants undergoing laparotomy under general anesthesia were recruited and divided into three groups by random digits table method with 20 cases each according to admitting time; when used the force- air warming system intraoperatively, the three groups were respectively setting on 45℃(automatic adjustment for 43 ℃ after 45 minutes), 43 ℃ and 38 ℃.The core temperature were respectively recorded before anesthesia and 15, 30, 45, 60 minutes after anesthesia (every 30 minutes after 1 hour).The hypothermia incidence and anesthesia recovery conditions were recorded simultaneously. Results There was no significant difference on the core temperature among three groups before anesthesia (P > 0.05). 30 minutes after the anesthetic, the core temperature of 45 ℃ group was (36.31±0.20) ℃,43 ℃ group was (36.32±0.24) ℃ and 38 ℃ group was (36.08±0.21) ℃.The differences among three groups was statistically significant (F=8.12, P < 0.01), but there was no significant difference between 45 ℃ group and 43 ℃ group (P > 0.05). 60 minutes after the anesthetic, the core temperature of 45 ℃ group was (36.39±0.26) ℃,43 ℃ group was (36.19±0.22) ℃ and 38 ℃ group was (35.92±0.15) ℃. The differences among three groups was statistically significant(F=25.19, P<0.01).The hypothermia incidence of 45℃group, 43℃ group,38℃ group was 10.0%(2/20), 25.0%(5/20), 50.0%(10/20)respectively and the differences among three groups was statistically significant( χ2=8.04, P<0.05). The time to complete consciousness of 45 ℃ group was (15.40±5.09) minutes,43 ℃ group was (19.80±4.10) minutes and 38 ℃ group was (22.00±4.36) minutes. The differences among three groups was statistically significant (F=10.96, P<0.01). The time to tracheal extubation of 45 ℃ group was (18.10±5.97) minutes, 43 ℃ group was (21.85±4.02) minutes and 38 ℃ group was (24.90±5.54) minutes.The differences among three groups was statistically significant (F=9.83, P<0.01). Conclusions The forced-air warming system can increase the infants′peripheral tissue heat content and reduce the heat losing.So that it will help decrease the intraoperative hypothermia incidence and shorten the anesthesia recovery period.Meanwhile the higher temperature of the forced-air warming system is setted ,the better effect it is.

Objective:To explore the effect of small private blended teaching combined with guided feedback in the training of specialist nurses in Operating Room.Methods:The cluster sampling was used to select 62 trainees who participated in the training of specialist nurses in Operating Room of the First Affiliated Hospital of Zhengzhou University in 2019 and 2020 as the research object. The trainees in 2019 and 2020 were divided into the control group ( n=32) and the experimental group ( n=30) . The experimental group adopted the small private online course (SPOC) teaching method combined with guided feedback, and the control group adopted the traditional teaching method. After the training, the two teaching methods were evaluated by theoretical assessment, operational assessment and self-designed questionnaires. Results:The theoretical knowledge, surgical safety verification, and surgical position placement scores of the specialist nurses in Operating Room of the experimental group were (89.90±3.92) , (91.37±3.57) , (92.03±2.98) , and the scores of the control group were (87.44±3.06) , (88.53±4.23) , (87.28±3.10) respectively, and the differences between the two groups were statistically significant ( P<0.05) . The students in the experimental group had a good evaluation of the effect of the SPOC teaching method combined with guided feedback, and their satisfaction was over 90%. Conclusions:The SPOC teaching method combined with guided feedback can improve the theoretical knowledge and operational ability of specialist nurses in Operating Room, and enhance the enthusiasm of students to learn, cultivate clinical thinking ability and humanistic care consciousness. The training effect is better than traditional teaching method, which is helpful to improve the teaching quality of specialized nursing in Operating Room.

Objective:To investigate the training status of robotic-assisted surgery nurses in hospitals with robotic-assisted surgery system in China, and to provide reference for the training and management of robotic-assisted surgery nurses.Methods:From August to December in 2021, hospitals with robotic-assisted surgery system in China were surveyed by a self-designed questionnaire distributed online.Results:The participants in the survey of 111 hospitals in 30 provinces, cities, autonomous regions and municipalities directly under the central government, nurses cooperated with robotic-assisted surgery exist the phenomenon of their own training was up to 96.40% (107/111) of hospital, 47.75% (53/111) of the hospital said the current training content also need to add other aspects of the course. Training duration of theoretical courses was 0-13 (2.86 ± 3.03) periods arranged by hospitals, and the training duration of practical courses was 1-60 (8.38 ± 9.91) d. 35.14% (39/111) of hospitals set up regular assessment after training, and the assessment cycle of them was 1-12 (4.08 ± 3.31) months. Many hospitals put forward suggestions on strengthening English training and attaching importance to team cooperation and so on.Conclusions:In our country, Robotic-assisted surgery nurses′ training has turned to that training themselves in operating rooms, the training time, form, content and other aspects have no uniform standard, strict admittance, standardization of specialist training , these are questions need to solve.

Objective? To explore the effects of health failure mode and effect analysis(HFMEA) in the safety management of intraoperative radiotherapy(IORT). Methods? The HFMEA group was set up to analyze the potential risks of breast cancer patients undergoing intraoperative radiotherapy from January 2014 to April 2018. The group listed the failed modes that need to be improved, identified the invalid steps that need intervention, determined the causes of the failure and calculated the risk priority number (RPN), created the safety management plans and put them into action. Finally, the outcomes were observed and analyzed. Results? After the improvement of the HFMEA, the patients' healing rate of stage-Ⅰ incision increased from 85.42% to 98.18% with statistical significance (χ2=4.184,P＜0.05). The patients' satisfaction degree scored (98.21±3.98)from the patients and (99.02±5.89)from the surgeons, both higher than those before improvement with statistical significance (t=5.24, 3.07;P＜0.05). After the improvement, the absorbed and scattered dose of the affected and contralateral skin of thyroid gland, and the absorbed and scattered dose of the affected and contralateral skin of lens were lower than those before improvement. Conclusions? Through prospectively controlling non-standard operation behaviors and optimizing the process, the application of HFMEA in the intraoperative irradiation after conservative surgery for breast cancer can ensure patients' safety and improve the quality of surgeries.

Objective:To formulate a safety check plan for intraoperative magnetic resonance imaging (IMRI) , and provide a reference for the management of the combined MRI operation room.Methods:Totally 207 intracranial mass lesion surgeries performed in the combined MRI operation room of the First Affiliated Hospital of Zhengzhou University in 2019 were selected. Based on the visual management theory, the "point-to-point" fixed homing method and the "four-party" safety checklist for IMRI were designed to adjust the surgical process. After optimization, the surgeons, anesthesiologists, itinerant nurses and magnetic resonance physicians who participated in the scan safety check were interviewed to evaluate the effect of process improvement. The interview data were collected and analyzed using Colaizzi's phenomenological seven-step analysis method.Results:The interviews with surgeons, anesthesiologists, itinerant nurses and magnetic resonance physicians could boil down to two themes: fixed-point placement of items could ensure the safety of IMRI; "four-party" safety check could ensure patients' safety.Conclusions:The optimized surgical process in the combined IMRI operation room and the scanning safety check plan can ensure the safe homing of non-compatible items, improve the efficiency of scanning safety check, and enhance the safety of IMRI.

Objective:To explore the effects of defect situation simulation method based on peer aid in teaching for undergraduate operating room nursing students.Methods:Totally 80 undergraduate nursing students admitted in 2016 who had their internship in the Operating Room at the First Affiliated Hospital of Zhengzhou University from September to December 2019 were selected by convenient sampling and randomly divided into the experimental group and the control group, with 40 cases in each group. Nursing students in the control group received traditional operating room nursing operation training, while nursing students in the experimental group were taught with the defect situational simulation method based on peer aid. The nursing skills assessment performance was compared between the two groups, and the teaching methods of the two groups of nursing students were investigated with an evaluation questionnaire.Results:The operating room nursing skills assessment performance of the experimental group was (92.88±4.29) , while that of the control group was (89.83±5.01) , the difference was statistically significant ( t=-2.925, P < 0.01) ; the score of nursing effects in the experimental group was 42.00 (40.00, 44.00) , whereas that of the control group was 39.00 (38.00, 40.00) , and the difference was statistically significant ( Z=-4.67, P<0.01) . Conclusions:The defect situation simulation method based on peer aid can better improve the operating room nursing skills of nursing students, help cultivate their teamwork awareness and problem-solving skills, promote the transformation of teaching concepts, and improve the quality of nursing teaching in the operating room.

Objective:To understand the real feelings and needs of postgraduate nursing students during standardized training, and provide a reference for managers to formulate more complete standardized training programs in the future.Methods:Using the phenomenological research method, totally 12 postgraduate nursing students of the First Affiliated Hospital of Zhengzhou University who had completed the two-year standardized training were selected by purposive sampling and received semi-structured interviews from August to October 2018, and the Colaizzi 7-step method was used to organize and analyze the data.Results:A total of 5 themes were extracted, namely, increased self-efficacy and improved core competence, negative psychological experience, demand for policy guarantees for scientific research, demand for personalized training programs and high-standard teaching staff, and demand for the promotion system and salary.Conclusions:The recognition of various aspects is dominant in postgraduate nursing students, but they have also many negative emotions and unmet needs. Managers should pay attention to their feelings and needs, and properly formulate suitable training programs, thereby giving full play to the advantages of standardized training.

Objective:To identify differences in association among visceral fat, body mass index, and waist circumference in Hans and Tibetans, and to investigate the associations between visceral adipose tissue and adipokine concentrations in the two ethnics.Methods:This is a mono-centric, cross-sectional observational study including 148 Hans and 150 Tibetans between 18 and 65 years old. The multivariate regression analysis was used in the study.Results:After adjustment of confounders, every 1 kg/m 2 increment of body mass index was coexisted with a larger increment of visceral adipose tissue in Han ethnic group than that in Tibetan [ β: 6.87(95% CI 4.25-9.49) vs 4.84(95% CI 2.57-7.11), P<0.01]. And increased waist circumference with 1 cm was accompanied by larger increment of visceral adipose tissue in Hans than in Tibetans [ β: 4.02(95% CI 3.15-4.89) vs 2.06(95% CI 1.75-3.44), P<0.01]. Tibetan ethnic group had higher levels of adiponectin and leptin than Han ethnic group [(57.06±32.52 vs 75.56±43.95) ng/ml, P<0.01; (98.55±100.46 vs 124.83±111.97) pg/ml, P=0.024]. After adjustment, significant association was documented between adiponectin levels and the presence of metabolic syndrome in Tibetans ( OR=0.97, 95% CI 0.95-0.99, P=0.007), whereas no association was observed in Hans ( OR=0.99, 95% CI 0.98-1.01, P=0.268). Conclusions:The ethnicity significantly affects the adipose distribution, with the same increase of body mass index or waist circumference, the Tibetans′ increase of visceral adipose tissue is less than that of Hans. The two ethnic groups may have their own unique metabolic characteristics.

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.

Objective:To investigate the prevalence and risk factors of diabetic retinopathy (DR) in patients in Tibet.Methods:A total of 239 patients with DR who received treatment in Department of Endocrinology and Metabolism, Hospital of Chengdu Office of People's Government of Tibet Autonomous Region from December 2017 to December 2018 were included in this study. They were divided into Han nationality and Zang nationality groups according to ethnicity. The condition of DR was evaluated with nonmydriatic ocular fundus photography according to the staging criteria of the severity of retinopathy.Results:The prevalence of DR in Tibet was 18.0％. The prevalence of DR in Tibetan and Han patients with diabetes was 17.5% and 19.2%, respectively. There was no significant difference in the prevalence of DR between Tibetan and Han patients with diabetes ( χ2 = 0.10, P = 0.754). Logistic regression analysis revealed that the risk factors of developing DR in Tibet included diabetes duration ( OR = 1.14, 95% CI: 1.05-1.24, P < 0.05), insulin therapy ( OR = 2.74, 95% CI: 1.09-6.89, P < 0.05), fasting plasma glucose ( OR = 1.37, 95% CI: 1.07-1.75, P < 0.05) and hypertension ( OR = 1.98, 95% CI: 1.02-3.86, P < 0.05). Diabetes duration and fasting plasma glucose are independent risk factors of DR. However, although elevated glycated hemoglobin levels were high in Tibet, they could not be used to predict the risk for developing DR ( OR = 1.01, 95% CI: 0.82-1.25, P > 0.05). Conclusion:Hyperglycemia is an important risk factor of developing DR in Tibet. However, elevated glycated hemoglobin levels cannot be used to predict the risk of developing DR in Tibet. Findings from this study fill the gap in the research on DR prevalence and ethic difference of DR prevalence, providing scientific evidence for prevention and treatment of DR in high-altitude areas.