Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Objective:To explore the effects of respiratory resistance training combined with active cycle of breathing techniques in nursing care for patients with lower cervical spinal cord injury.Methods:From April 2017 to March 2019, we selected 78 patients with lower cervical spinal cord injury in Trauma Emergency Center of the Third Affiliated Hospital of Hebei Medical University as subjects. All patients were divided into observation group and control group with the method of random number table, 39 cases in each group. Control group carried out the respiratory system nursing with the self-developed compound sequential technology on sputum exclusion. On the basis of that in control group, observation group implemented the resistance inspiratory training and expiratory training with the respiratory resistance training combined with active cycle of breathing techniques. We compared the volume of sputum excretion, pulmonary function[forced vital capacity (FVC) , forced expiratory volume in one second (FEV1) , peak expiratory flow (PEF) and maximal expiratory pressure (MEP) ] and incidences of pulmonary complications during hospitalization between two groups.Results:A total of four weeks after training, the volume of sputum excretion of observation group on the fifth day after surgery was lower than that of control group with a statistical difference ( P<0.05) . There were four pulmonary function indexes (FVC、FEV1、PEF、MEP) in observation group better than those in control group with statistical differences ( P<0.05) . The incidence of pulmonary complications of observation group was lower than that of control group with a statistical difference ( P<0.05) . Conclusions:Respiratory resistance training combined with active cycle of breathing techniques can promote the early excretion of sputum of patients with lower cervical spinal cord injury, improve the pulmonary function and reduce the incidence of pulmonary complications.

Objective To explore the clinical effects of individualized nutritional support on patients with acute complete cervical spinal cord injury. Methods The patients with acute complete cervical spinal cord injury in the Trauma Emergency Center of a hospital between January 2011 and December 2012 were randomly divided into experimental group (n=49) and control group (n=54). The diets of patients in the control group were provided by family members guided by nurses in hospital, and the patients in the experimental group were given individualized nutritional supports which were formulated by nutrition consultation according to patients′specific conditions. The incidence of complications ( constipation, lung infection, hyponatremia and hypoproteinemia) within 14d and the average stay in hospital in two groups were compared. Results In the experimental group, the incidence of constipation, lung infection, hyponatremia and hypoproteinemia were significantly lower and the average stay in hospital was shorter than those in the control group. The differences between the two groups were statistically significant (P < 0. 05). Conclusions Providing individualized nutritional support for patients with acute complete cervical spinal cord injury can reduce the incidence of complications and the average stay in hospital.

Objective To explore the application of compound sequential technology on sputum exclusion for patients with cervical spinal cord injury. Methods A total of 86 patients with cervical spinal cord injury ( CSCI) were divided into intervention group and control group from January 2011 to December 2013 in our hospital on average. The patients of intervention group adopted compound sequential technology on sputum exclusion, while the patients in the control group underwent conventional nursing measures. We evaluated the occurrence of pulmonary infection and atelectasis, and the usage of artificial airway. Results In the intervention group, the incidence of lung infection and atelectasis (9. 3%) was lower than that of the control group (37. 2%), and the difference was statistically significant (χ2 =9. 382,P< 0. 05). The cure time in the intervention group was shorter that of the control group (t = -6. 339,P <0. 05). Utilization rate of artificial airway in the intervention group was 7. 0% compared with 30. 2% in the control group (χ2 =7. 679,P<0. 05). The length of carrying tube in the intervention group was lower than that of the control group (t = -5. 490,P <0. 05). Conclusions The compound sequential technology can improve the effect of sputum exclusion in patients with CSCI, decrease pulmonary infection and atelectasis, shorten the time of carrying tube, and enhance cure rate.

Objective To evaluate Janus kinase (JAKs) and Suppressors of cytokine signaling(SOCSs) expression in myocardium after endurance training. Methods 30 male Sprague-Dawley rats undertook 10 weeks grade treadmill training program and were sacrificed at 0 and 24 h respectively after the last exercise. JAK1,JAK2,JAK3 and SOCS1 ,SOCS2,SOCS6 expression in the myocardium were determined by im munohistochemistry method. Results The percentage of JAK1 positive cell significantly increased immediately after last running and recovered to the sedentary level 24 hrs after exercise;The percentage of JAK2 positive cell significantly increased immediately after last running and continuously at a higher level 24 hrs after exercise (P<0.01;P<0.05); JAK.3 showed no significant change either immediately or 24 hrs after exercise (P>0.05). The percentage of SOCS1 and SOCS2 positive cell also significantly increased both immediately and 24 hrs after exercise (P<0.01 ;P<0.05). However, the percentage of SOCS6 positive cell showed no significant change either immediately or 24 hrs after exercise(P>0.05). Conclusion Endurance training could induce different responses of JAK1,JAK2 and JAK3. The increased expressions of JAK1 and JAK2 might indicate the changes of JAK/STAT signal pathway in regulating myocardial function. The increased expressions of SOCS1 and SOCS2 after endurance training might indicate the increased exertion in regulating JAK/STAT signal pathway in cardiac muscle.