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 clinicopathologic features differences between tall cell variant of papillary thyroid cancer (TCV-PTC) and PTC with tall cell features (PTC-TCF) and the factors influencing efficacy of 131I therapy in patients with TCV-PTC and PTC-TCF. Methods:A retrospective analysis was conducted on 84 patients (28 males, 56 females, age 43.5(35.0, 55.0) years) with pathologically confirmed TCV-PTC or PTC-TCF and who were treated with 131I therapy from January 2018 to June 2023 in the Department of Nuclear Medicine, the Affiliated Hospital of Qingdao University. The patients were divided into structural incomplete response (SIR) group and non-SIR group according to 131I treatment response. Data differences were analyzed by Wilcoxon rank sum test, Fisher exact test, or Mann-Whitney U test. Variables with P<0.1 were enrolled in logistic multivariate regression analysis. The ROC curve was used to obtain the cut-off value of stimulated thyroglobulin (sTg). Results:A total of 37 patients with non-SIR and 6 patients with SIR were found in TCV-PTC group ( n=43), and 33 non-SIR and 8 SIR cases were found in PTC-TCF group ( n=41). Univariate analysis revealed that sTg differed significantly between non-SIR patients and SIR patients in TCV-PTC group ( Z=-2.81, P=0.003), while no significant differences observed for sex, age, multifocality, capsular invasion, T stage, N stage, B-Raf proto-oncogene, serine/threonine-protein kinase (BRAF) V600E mutation, initial recurrence risk, number of metastatic lymph nodes, maximum tumor diameter ( Z values: from -0.74 to -0.11, all P>0.05). In TCV-PTC group, sTg also differed significantly between non-SIR patients and SIR patients ( Z=-4.40, P<0.001), while the other clinical factors above and the proportion of tall cells showed no significant difference ( Z values: from -1.90 to -0.22, all P>0.05). The logistic regression analysis confirmed sTg as an independent risk factor of SIR in both TCV-PTC group (odds ratio ( OR) = 25.156, 95% CI: 2.245-281.812, P=0.009) and PTC-TCF group ( OR=19.214, 95% CI: 2.537-145.502, P=0.004). The ROC curve indicated that the cut-off value of sTg for predicting SIR was 20.75μg/L in TCV-PTC group and 18.55μg/L in PTC-TCF group. Conclusions:sTg is the independent risk factor for predicting the poor prognosis of patients with TCV-PTC (sTg≥20.75μg/L) and PTC-TCF (sTg≥18.55μg/L). However, other clinical characteristics show no statistical difference between TCV-PTC group and PTC-TCF group, suggesting that the invasiveness of PTC-TCF may not be lower than that of TCV-PTC, which close attention should be paid to in clinical practice.

Objective To conduct a bibliometric and visual analysis of literature related to anti-microbial therapy for febrile neutropenia(FN)in recent years and explore the research trends and hotspots in this field.Methods The Web of Science database was searched to analyze the publica-tion trends,countries/regions,research institutions,journal distributions,author influences,and keyword co-occurrences.VOSviewer,CiteSpace,and Scimago Graphica software were utilized for mapping analysis to present the research hotspots and development trends of antimicrobial therapy for FN.Results A total of 536 articles were included.The average annual number of publications was approximately 43 from 2014 to 2019 and approximately 54 from 2020 to 2024,showing an upward trend.The United States had the highest number of publications(134 articles,accounting for 25.00％).The institution with the most publications was the University of Melbourne(18 articles).The author with the most publications was GUDIOL C(9 articles).Keyword clustering analysis revealed that the research hotspots were mainly concentrated in areas such as"febrile neutropenia","antimicrobial stewardship","immunocompromised hosts","risk assessment","cost-effectiveness analysis","empirical therapy"and"Staphylococcus aureus".Conclusion The number of publications on re-search related to antimicrobial therapy for FN has shown an upward trend in recent years.Antimicro-bial stewardship,treatment of immunocompromised hosts,control of drug resistance,and personalized therapy may become the main research directions in the future.

Objective: To investigate the efficacy and incidence of adverse reactions of therapeutic erythrocytapheresis in high altitude polycythemia (HAPC) population. Methods: A retrospective study was conducted on 243 HAPC patients who were either native residents or long-term workers in Xizang and underwent therapeutic erythrocytapheresis in the Chengdu Office Hospital of the People's Government of Xizang Autonomous Region from 2021 to 2023. A comparative study was carried out on the changes in blood routine, vital signs, skin color, serum iron metabolism data, and the incidence of adverse reactions before and after the procedure. Results: After erythrocytapheresis, significant decreases were observed in red blood cell (RBC) count (7.06±0.89×10 vs 6.08±0.93×10 /L, P<0.001], hemoglobin (HGB, 211.59±17.99 vs 182.76±19.83 g/L, P<0.001), hematocrit (Hct) [(65.30±6.45)% vs (55.56±8.12)%, P<0.001], serum iron (14.46±4.38 vs 11.77±3.78 μmol/L, P=0.003), total iron-binding capacity (126.62±4.47 vs 123.73±3.77 μmol/L, P=0.002), transferrin (1.88±0.41 vs 1.77±0.12 g/L, P=0.023), transferrin saturation [(11.32±3.11)% vs (9.43±2.78)%, P=0.004], serum ferritin (832.4±295.6 vs 665.3±249.2 ng/mL, P<0.001), systolic blood pressure (123.86±14.43 vs 118.51±13.68 mmHg, P<0.001) and diastolic blood pressure (81.68±9.54 vs 74.28±7.61 mmHg, P<0.001). In contrast, platelet count (Plt, 137.21±46.21 ×10 vs 147.94±50.66 ×10 /L, P<0.001) and oxygen saturation [(93.97±3.29)% vs (95.84±2.27)%, P<0.001] increased. No significant differences were found in white blood cell (WBC) count [5.35 (4.59, 6.44)×10 /L vs 5.43 (4.54, 6.53) ×10 /L, P=0.690], unsaturated iron-binding capacity (112.15±0.50 vs 111.96±0.25 μmol/L, P=0.074) and pulse rate (73.42±11.28 vs 73.19±7.18 beats/min, P=0.750). Furthermore, skin color of the face (conjunctiva, lips) and palms mitigated after therapeutic erythrocytapheresis, changing from purplish-red to red. The total incidence of adverse reactions during erythrocytapheresis was 13.98% (34/243), including citrate toxicity 12.75% (31/243), puncture site hematoma 0.82% (2/243) and blood volume imbalance 0.41% (1/243). Conclusion: Therapeutic erythrocytapheresis could rapidly decrease HCT, Hb, serum iron, transferrin and transferrin saturation levels in HAPC patients, with a low incidence of adverse reactions. Therefore, therapeutic erythrocytapheresis has broad clinical application prospects in Xizang Autonomous Region.

Objective:To explore the multiple mediating roles of intrinsic motivation and proactive behavior in the influence mechanism of perceived overqualification on the information literacy of Operating Room nurses engaged in organ transplantation.Methods:On November 2023, 308 Operating Room nurses engaged in organ transplantation from 12 hospitals in China were selected for the survey using convenience sampling method. General information questionnaire, Information Literacy Self-Rating Scale for Clinical Nurses, the 9-item Scale of Perceived Over Qualification, Intrinsic Motivation Scale, and Proactive Behavior Scale were used to investigate and to construct the chain mediating model.Results:A total of 308 questionnaires were collected and 294 questionnaires were valid, with a valid recovery rate of 95.45%. The total scores of information literacy, perceived overqualification, intrinsic motivation and proactive behavior of 294 Operating Room nurses engaged in organ transplantation were (133.95±19.07), (23.71±7.82), (76.47±13.38) and (38.01±6.31) respectively. The indirect effect of perceived overqualification of Operating Room nurses engaged in organ transplantation on information literacy existed, with a total indirect effect value of -0.348. The specific indirect effect of intrinsic motivation was 40.80% of the total indirect effect, the specific indirect effect of proactive behavior was 31.03% of the total indirect effect, and the chain mediating effect of intrinsic motivation and proactive behavior was 28.16% of the total indirect effect.Conclusions:Multiple mediating roles of intrinsic motivation and proactive behavior in the influence mechanisms of perceived overqualification on the information literacy of Operating Room nurses involved in organ transplantation are established. Managers can improve the information literacy of Operating Room nurses engaged in organ transplantation by reducing their perceived overqualification and stimulating intrinsic motivation and proactive behavior.

Objective:To explore the multiple mediating roles of intrinsic motivation and proactive behavior in the influence mechanism of perceived overqualification on the information literacy of Operating Room nurses engaged in organ transplantation.Methods:On November 2023, 308 Operating Room nurses engaged in organ transplantation from 12 hospitals in China were selected for the survey using convenience sampling method. General information questionnaire, Information Literacy Self-Rating Scale for Clinical Nurses, the 9-item Scale of Perceived Over Qualification, Intrinsic Motivation Scale, and Proactive Behavior Scale were used to investigate and to construct the chain mediating model.Results:A total of 308 questionnaires were collected and 294 questionnaires were valid, with a valid recovery rate of 95.45%. The total scores of information literacy, perceived overqualification, intrinsic motivation and proactive behavior of 294 Operating Room nurses engaged in organ transplantation were (133.95±19.07), (23.71±7.82), (76.47±13.38) and (38.01±6.31) respectively. The indirect effect of perceived overqualification of Operating Room nurses engaged in organ transplantation on information literacy existed, with a total indirect effect value of -0.348. The specific indirect effect of intrinsic motivation was 40.80% of the total indirect effect, the specific indirect effect of proactive behavior was 31.03% of the total indirect effect, and the chain mediating effect of intrinsic motivation and proactive behavior was 28.16% of the total indirect effect.Conclusions:Multiple mediating roles of intrinsic motivation and proactive behavior in the influence mechanisms of perceived overqualification on the information literacy of Operating Room nurses involved in organ transplantation are established. Managers can improve the information literacy of Operating Room nurses engaged in organ transplantation by reducing their perceived overqualification and stimulating intrinsic motivation and proactive behavior.

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 clinicopathologic features differences between tall cell variant of papillary thyroid cancer (TCV-PTC) and PTC with tall cell features (PTC-TCF) and the factors influencing efficacy of 131I therapy in patients with TCV-PTC and PTC-TCF. Methods:A retrospective analysis was conducted on 84 patients (28 males, 56 females, age 43.5(35.0, 55.0) years) with pathologically confirmed TCV-PTC or PTC-TCF and who were treated with 131I therapy from January 2018 to June 2023 in the Department of Nuclear Medicine, the Affiliated Hospital of Qingdao University. The patients were divided into structural incomplete response (SIR) group and non-SIR group according to 131I treatment response. Data differences were analyzed by Wilcoxon rank sum test, Fisher exact test, or Mann-Whitney U test. Variables with P<0.1 were enrolled in logistic multivariate regression analysis. The ROC curve was used to obtain the cut-off value of stimulated thyroglobulin (sTg). Results:A total of 37 patients with non-SIR and 6 patients with SIR were found in TCV-PTC group ( n=43), and 33 non-SIR and 8 SIR cases were found in PTC-TCF group ( n=41). Univariate analysis revealed that sTg differed significantly between non-SIR patients and SIR patients in TCV-PTC group ( Z=-2.81, P=0.003), while no significant differences observed for sex, age, multifocality, capsular invasion, T stage, N stage, B-Raf proto-oncogene, serine/threonine-protein kinase (BRAF) V600E mutation, initial recurrence risk, number of metastatic lymph nodes, maximum tumor diameter ( Z values: from -0.74 to -0.11, all P>0.05). In TCV-PTC group, sTg also differed significantly between non-SIR patients and SIR patients ( Z=-4.40, P<0.001), while the other clinical factors above and the proportion of tall cells showed no significant difference ( Z values: from -1.90 to -0.22, all P>0.05). The logistic regression analysis confirmed sTg as an independent risk factor of SIR in both TCV-PTC group (odds ratio ( OR) = 25.156, 95% CI: 2.245-281.812, P=0.009) and PTC-TCF group ( OR=19.214, 95% CI: 2.537-145.502, P=0.004). The ROC curve indicated that the cut-off value of sTg for predicting SIR was 20.75μg/L in TCV-PTC group and 18.55μg/L in PTC-TCF group. Conclusions:sTg is the independent risk factor for predicting the poor prognosis of patients with TCV-PTC (sTg≥20.75μg/L) and PTC-TCF (sTg≥18.55μg/L). However, other clinical characteristics show no statistical difference between TCV-PTC group and PTC-TCF group, suggesting that the invasiveness of PTC-TCF may not be lower than that of TCV-PTC, which close attention should be paid to in clinical practice.

Objective:To evaluate the effects of the defect situational objective structured clinical examination (OSCE) in the training of specialized nurses in the operating room, and provide a new idea for the training of specialized nurses in the operating room.Methods:A quasi experimental study was used in this study. A total of 78 nurses who participated in the training of the operating room specialized nurses in Henan Province in 2022 and 2023 which were organized by the First Affiliated Hospital of Zhengzhou University were selected by cluster sampling method. The nurses who participated in the training in 2022 and 2023 were assigned to the control group (38 participants) and the experimental group (40 participants), respectively. Nurses in the experimental group received defect situational OSCE, while nurses in the control group received conventional teaching. After the training, the effect of the two teaching methods was evaluated by skill operation assessment results and Clinical Thinking Ability Assessment Scale.Results:There were 4 males and 34 females in the control group, aged (30.03 ± 4.33) years old, and 3 males and 37 females in the experimental group, aged (29.93 ± 3.95) years old. The scores of the verification and handover of surgical patients, surgical position placement and the occupational exposure protection were (91.80 ± 2.95), (90.38 ± 3.66), (91.10 ± 3.26) points in the experimental group and were (89.08 ± 3.21), (87.84 ± 3.49), (88.39 ± 4.21) points in the control group, the differences between the two groups were statistically significant ( t = 3.91, 3.13, 3.18, all P<0.05). The total score of clinical thinking ability in the experimental group was (80.66 ± 1.85) points, which was higher than (77.77 ± 1.62) points in the control group, the difference between the two groups was statistically significant ( t = 7.31, P<0.05). The evaluation of the teaching effect in the experimental group was better, and the satisfaction rate was 92.5%(37/40)-100.0%(40/40). Conclusions:The application of defect situational OSCE teaching method in the training of operating room nurses could better improve the operational ability and help to improve the clinical thinking ability of nurses. The training effect is superior to the conventional teaching method, and it is worthy of clinical application.

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.