Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective To investigate the predictors of systemic inflammatory response syndrome (SIRS) in patients with acute ischemic stroke. Methods The patients with acute ischemic stroke admitted to hospital from January 2010 to April 2014 were enroled. The demographics, vascular risk factors, baseline clinical data, and laboratory tests in both groups were colected. Flow cytometry was used to analyze the peripheral blood T helper cel (Th) subgroup. Double antibody sandwich enzyme-linked immunosorbent assay was used to detect the levels of peripheral blood interferon-γ (IFN-γ) and interleukin-4 (IL-4). Results A total of 143 patients with acute ischemic stroke were enroled, including 56 in a SIRS group and 87 in a non-SIRS group. Univariate analysis showed that there were significant differences in the history of hypertension, history of stroke, baseline systolic blood pressure, low-density lipoprotein cholesterol level, National Institutes of Health Stroke Scale (NIHSS) score, percentage of Th1 cels, and IFN-γ concentration in patients of both groups (al P < 0. 05). Multivariate logistic regression analysis showed that the NIHSS score ≥6 (odds ratio [ OR] 2. 40, 95% confidence interval [ CI] 1. 24 - 5. 15, P = 0. 008), decreased percentage of Th1 cels (OR 2. 81, 95% CI 1. 51 - 6. 83, P = 0. 013), and decreased IFN-γ concentration (OR 4. 63, 95% CI 1. 01 - 9. 72, P = 0. 004) were the independent predictive factors for occurring SIRS in patients with acute ischemic stroke. Conclusions Severe neurological deficit, decreased percentage of Th1 cels or decreased IFN-γ level may increase the risk of acute ischemic stroke patients with SIRS.