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.

Hip fracture in the elderly is characterized by high incidence, high disability rate, and high mortality and has been recognized as a public health issue threatening their health. Surgery is the preferred choice for the treatment of elderly patients with hip fracture. However, lower extremity deep venous thrombosis (DVT) has an extremely high incidence rate during the perioperative period, and may significantly increase the risk of patients′ death once it progresses to pulmonary embolism. In response to this issue, the clinical guidelines and expert consensuses all emphasize active application of comprehensive preventive measures, including basic prevention, physical prevention, and pharmacological prevention. In this prevention system, basic prevention is the basis of physical and pharmacological prevention. However,there is a lack of unified and definite recommendations for basic preventive measures in clinical practice. To this end, the Orthopedic Nursing Professional Committee of the Chinese Nursing Association and Nursing Department of the Orthopedic Branch of the China International Exchange and Promotive Association for Medical and Health Care organized relevant nursing experts to formulate Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture ( version 2024) . A total of 10 recommendations were proposed, aiming to standardize the basic preventive measures for lower extremity DVT in elderly patients with hip fractures during the perioperative period and promote their subsequent rehabilitation.

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 effects of folic acid combined with vitamin B12 on the vascular cognitive impairment (VCI)and homocysteine(Hcy)of patients with hypertension and cerebral stroke. METHODS:80 VCI patients with hypertension and cerebral stroke were regarded as observation group,and another 20 healthy volunteers were regarded as healthy control group. Observation group was treated with enhanced homogenized meal 300-500 ml,3 times a day+Folic acid tablet 5 mg,3 times a day+Vitamin B12 tablet 25 μg,3 times a day. Observation groups were treated for continuous 2 months with no nasal administration by themselves. The Mini-Mental State Examination(MMSE)score,the level of folic acid,vitamin B12 and Hcy before and after treat-ment were observed and compared with healthy control group,and the incidence of adverse reactions was recorded. RESULTS:Af-ter treatment,MMSE score,the level of folic acid,vitamin B12 in observation group were significantly higher than before and low-er than healthy control group,the level of Hcy was significantly lower than before and higher than healthy control group,the differ-ences were statistically significant(P<0.05). The incidence of adverse reactions was 5.00%. There were no serious adverse reac-tions. CONCLUSIONS:Folic acid combined with vitamin B12 can reduce the cognitive impairment degree of patients with hyperten-sion,cerebral stroke and vascular cognitive impairment and level of Hcy,with good safety.

OBJECTIVE:To observe the clinical efficacy and safety of Shenmai injection combined with Trimetazidinee tablet in the treatment of hypothyroid heart disease. METHODS:64 patients with hypothyroid heart disease were randomly divided into control group and observation group. Patients in 2 groups were conventional treatment. Based on the treatment,control group was treated with Trimetazidine tablets 20 mg,orally,3 times a day;based on the treatment in control group,observation group was ad-ditionally treated with Shenmai injection 40 ml by intravenous infusion,once a day. The treatment course was 2 months. The clinic data was observed,including clinical efficacy,and T3,T4,TSH,LVEF,LVEDD and LVESD before and after treatment,pericar-dial effusion depth and incidence of adverse reactions. RESULTS:The total effective rate in observation group was significantly higher than control group(P<0.05). After treatment,T3 and T4 in 2 groups were significantly higher than before,TSH and LVESD were significantly lower than before(P<0.05),however,the difference was not statistically significant between 2 groups (P>0.05);LVEF in 2 groups was significantly higher than before,observation group was higher than control group,LVEDD and pericardial effusion depth were significantly lower than before,observation group was lower than control group(P<0.05). There were no obrious adverse reactions during treatment. CONCLUSIONS:Based on the conventional treatment,Shenmai injection com-bined with trimetazidinee has better efficacy than only trimetazidinee in the treatment of hypothyroid heart disease,with similar safety.

Objective To study the analysis of folic acid combined with vitamin for level two ischemic stroke prevention effect. Methods From April 2013 to January 2014 in our hospital , selected the patients with stroke in 100 cases as the research object. In digital method were randomly divided into observation group (50 cases) and control group (50 cases). The patients in the observation group was taken folic acid combined with vitamin , the control group only was given vitamins, in all patients on admission and at discharge on the plasma levels of Hcy, D-two dimer, fibrinogen, three glycerol, total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol level, the effect of folic acid combined with the vitamin was observed. Results No significant differences between the two groups before treatment, plasma Hcy levels (P>0.05) in different ways, the observation group after treatment, the plasma Hcy levels were significantly lower than the control group , with significant difference ( P<0 . 05 ) . Two groups by different ways of treatment, the observation group was best accounted for 70% (35/50), the excellent and good rate was as high as 98% (49/50), significantly higher than the control group 44% (22/50) and 74% (37/50), with significant difference (P<0.05). On two groups of different ways of treatment of cerebral was stroke recurrence and score in patients with SIAS were compared, the recurrence rate of the observation group was lower than the control group, with significant difference (P<0.05), the SIAS score was significantly higher than that of the control group, with significant difference (P<0.05). Conclusion For the patients with stroke, should the use of folic acid combine with vitamin two level of prevention. The combine uses of folic acid and vitamin , can effectively reduce the incidence of stroke and recurrence rate.

[Objective]To investigate the regular pattern of references quoted in theses of Orthopedic Journal of China from year 2005 to 2006,and to study the characteristics and experiences of reference quoting in Chinese orthopedic academic sphere.[Method]Forty-eight issues of Orthopedic Journal of China from year 2005 to 2006 were downloaded from the website www.chinajournal.net.cn.There were 466 theses about clinical research.All references in these theses were collected as origin of data.Excel software was applied to analyze all references.[Result]References were found in all 466 papers with the reference rate of 100%.The average reference amount in each thesis was 7.15(3 334/466).A total of 3110 references were from journals(93.28%)and 214 references were from monographs(6.42%).The Price Index reached 52.13%.And the number of self-quoted references reached 614 with the rate of self-quoting of 18.42%(614/3 334).References from Chinese and foreign journals with the first 20 highest being-quoting rates were collected,and it reached 56.12% of all references.[Conclusion]The content of references in Orthopedic Journal of China ranges widely.The main quoting origin is from journals.The mainly-quoted language is English,and references from other languages are rarely quoted.Most references showed new and original ideas.