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.

The polyfoliate perforator flap is a new type of flap that was developed on the basis of the traditional polyfoliate myocutaneous flap, polyfoliate fascial flap and perforator flap. It overturns the traditional idea that the deep fascial vascular network is the fundamental for a survival of the flap, and enables the flaps to achieve the best profile and function of the recipient areas with minimal damage to the donor area. In order to improve the understanding of the polyfoliate perforator flap and further standardise its clinical application, this paper forms a consensus on the definition, classification, indications, operative points and precautions of the polyfoliate perforator flap, so as to provide references in diagnosis and treatment process and practical application for the surgeons.

Objective:To construct a core competency indicator system for oncology advanced practice nurses.Methods:This study is a cross-sectional study. A preliminary draft of the core competency indicator system for oncology advanced practice nurses was developed through literature review and expert group coordination from June to November 2022. The core competency indicator system for oncology advanced practice nurses was established using the Delphi method for expert consultation and the analytic hierarchy process.Results:A total of 54 experts from 11 hospitals and four medical schools in 10 provinces and municipalities directly under the central government across the country were included in two rounds of expert consultation. The effective response rates of the questionnaire were all 100%, with an expert authority coefficient of 0.90, Kendall coordination coefficients of 0.089 to 0.179 and 0.101 to 0.176 ( P<0.01). The final established core competency indicator system for oncology advanced practice nurses included seven primary indicators and 69 secondary indicators. Conclusions:The core competency indicator system for oncology advanced practice nurses is comprehensive and has the characteristics of specialized oncology nursing, and the construction process is scientific and reliable, laying the foundation for future training of oncology advanced practice nurses.

The polyfoliate perforator flap is a new type of flap that was developed on the basis of the traditional polyfoliate myocutaneous flap, polyfoliate fascial flap and perforator flap. It overturns the traditional idea that the deep fascial vascular network is the fundamental for a survival of the flap, and enables the flaps to achieve the best profile and function of the recipient areas with minimal damage to the donor area. In order to improve the understanding of the polyfoliate perforator flap and further standardise its clinical application, this paper forms a consensus on the definition, classification, indications, operative points and precautions of the polyfoliate perforator flap, so as to provide references in diagnosis and treatment process and practical application for the surgeons.

Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.

AIM: To observe the effect of acute normovolemic hemodilution (ANH) autologous blood transfusion on the EEG bispectral index and muscle relaxation in elderly patients undergoing orthopedic surgery to explore the influence of autologous blood transfusion containing anesthetic components on the quality and safety of postoperative anesthesia recovery. METHODS: Forty patients, aged 65-75, weighing 55-80 kg, ASA grade I-II, with an estimated intraoperative blood loss of more than 600 mL, were selected for elective orthopedic surgery. The patients were randomly divided into two groups (n=20): group A was given acute normovolemic hemodilution (ANH), and the target value of Hct was 28%-30% after induction of anesthesia; group B was the control group which was given routine fluid infusion during operation without ANH. Bispectral index (BIS), TOF values and plasma concentrations of propofol and cisatracurium were measured at the beginning of autotransfusion (T

Objective To compare the features of different heating modes cauterization mode and standard ablation mode of Cool-tip on coagulation zone and thermal field distribution in order to provide references for focused and accurate vascular occlusion and explore the primary efficacy of Cool-tip applied to intrahepatic vascular occlusion in living dogs Methods Ex-vivo porcine livers were ablated for 2 4 6 8 minites with cauterization mode and standard ablation mode respectively and the long- and short-axis diameters in the greatest dimension were compared The tissue temperature around the tip midpoint and end of the exposed part of radiofrequency electrode were measured under the circumstance of 4 min ablation by the two modes respectively Animal experiment the intrahepatic vessels of 2 Beagles were ablated with cauterization mode one procedure for each animal and contrast-enhanced ultrasound was used to evaluate the perfusion change of liver tissue Gross anatomy and pathological examination of the liver was performed after 1 week Results In the 2 min 4 min 6 min and 8 min ablation the coagulation volume of cauterization mode and standard ablation mode were 1 01 ± 0 41 cm 3 vs 2 95 ± 0 74 cm 3 1 47 ± 0 33 cm 3 vs 5 03±1 06 cm 3 2 29±0 49 cm 3 vs 9 23±2 53 cm 3 2 70±0 24 cm 3 vs 1 5 89±0 77 cm 3 The coagulation volume was significant smaller in cauterization mode than in standard ablation mode P <0 05 for all The peak temperature of cauterization mode presented on the tip of electrode which averaged 94 4℃ in maximum and maintain around 70 ℃ in the equilibrium phase The peak temperature of standard mode presented on the midpoint of the electrode which periodically variated between 70 ℃- 100 ℃ The result of the animal experiment showed that cauterization mode could be used to occlude the intrahepatic vessel in vivo which induced the ischemia and necrosis in the corresponding area Conclusions Cauterization mode and standard alation mode of Cool-tip have different characteristic in terms of coagulation zone and thermal distribution and carterization mode may have a promising application in intrahepatic vascular occlusion.

Objectives To investigate the correlation between dietary fatty acids intake of pregnant women and neonatal anthropometry at birth. Methods Women in early pregnancy were recruited with appropriate value of weight gain in pregnancy. Instant photography was used to assess the dietary situation in both the second trimester and the third trimester to calculate the intakes of food, energy, macronutrients, and fatty acids. The body weight, height and BMI at birth were evaluated with Z scores. The correlation between dietary fatty acids of pregnant women and neonatal anthropometry at birth were analyzed. Results There were 516 pregnant women recruited in this study. The average intakes of polyunsaturated fatty acids (PUFA) and the proportion of total fatty acids in the two trimesters were 15 . 09 g/d, 23 . 93% and 17 . 18 g/d, 24 . 86%. In the second trimester the intakes of n-6 and n-3 PUFA were 14 . 23 g/d and 3 . 45 g/d, and in the third trimester, n-6 and n-3 PUFA were 16 . 08 g/d and 3 . 81 g/d, the average intakes in the third trimester were signiifcantly higher than those in the second trimester (P??0 . 05 ). The intake of DHA ( 64 . 43 mg/d) in the second trimester was lower than that in the third trimester 75 . 12 mg/d, (P??0 . 05 ).The dietary intakes of n-3 PUFA, n-6 PUFA and n-6/n-3 ratio in the second trimester were positively correlated with neonatal BMI r=0 . 142~0 . 189 , P??0 . 05 ). Conclusions The dietary ratio of n-6/n-3 PUFA in the second trimester was positively correlated with neonatal BMI, suggesting that moderately increasing the intake of n-3 PUFA may play a positive role in reducing childhood obesity.

When the body is attacked by trauma and infection,the serum C-reactive protein( CRP) con-centration which is produced by the liver will increase.CRP participates in the body′s humoral immunity through regulating the phagocytic cells to clear the pathogenic bacteria and necrotic tissue.The occurrence and develop-ment of malignant tumor is associated with complex inflammatory response pathway.Serum CRP concentration will change with the progress and remission of tumor.CRP is associated with differentiation of benign and malignant, the early diagnosis,the pathological stage,the lymph node metastasis,the organizational characteristics,the prog-nosis,and the treatment of malignant tumor.It is expected to be a clinical screening indicator of malignant tumor.