OBJECTIVE To analyze occupational exposure to sharps injuries among medical staff in different posi-tions in a three-A hospital.METHODS A retrospective collection of all sharps injury cases reported from 2018 to 2023 in a general hospital was conducted.The basic characteristics,high-risk links,involved instruments,post-exposure emergency treatment and follow-up situations were analyzed,while sharps injury characteristics of medi-cal staff in different positions were classified and discussed.RESULTS Over six years,340 sharps injuries occurred with the highest incidence among interns(2.70 cases/100 FTE·year)and the lowest among logistics staff(1.05 cases/100 FTE·year).Jun.was the month with the highest incidence,averaging 7.33 cases.High-risk links in-cluded instruments handling,placing instruments into sharp containers and removing needles from rubber or other barriers,accounting for 76.47%.Nurses experienced injuries mostly occurred in general wards and were related to scalp needles;doctors mostly occurred in operating rooms and were due to surgical instruments;interns were pri-marily injured by blood collection needles;pharmacists and medical technicians were related to ampoule handling;while logistical staff were mostly injured by hollow needles and glass fragments from waste disposal.Nurses and doctors were the main injured groups,with a higher incidence among females(25-<35 years)and males(less than five years of work experience).The exposure source was mainly hepatitis B virus(HBV)infection.Post-ex-posure treatment was primarily standardized emergency treatment,but a higher proportion of non-standardized treatment was observed among logistics staff.Follow-up reports showed that interns and logistical staff had lower submission rates and lower training coverage.CONCLUSIONS Significant differences exist in sharps injury charac-teristics among medical staff in different positions.Attention should be paid to position-specific high-risk links and instruments.Targeted training and occupational health management should be strengthened to effectively prevent occupational exposure.

OBJECTIVE To analyze occupational exposure to sharps injuries among medical staff in different posi-tions in a three-A hospital.METHODS A retrospective collection of all sharps injury cases reported from 2018 to 2023 in a general hospital was conducted.The basic characteristics,high-risk links,involved instruments,post-exposure emergency treatment and follow-up situations were analyzed,while sharps injury characteristics of medi-cal staff in different positions were classified and discussed.RESULTS Over six years,340 sharps injuries occurred with the highest incidence among interns(2.70 cases/100 FTE·year)and the lowest among logistics staff(1.05 cases/100 FTE·year).Jun.was the month with the highest incidence,averaging 7.33 cases.High-risk links in-cluded instruments handling,placing instruments into sharp containers and removing needles from rubber or other barriers,accounting for 76.47%.Nurses experienced injuries mostly occurred in general wards and were related to scalp needles;doctors mostly occurred in operating rooms and were due to surgical instruments;interns were pri-marily injured by blood collection needles;pharmacists and medical technicians were related to ampoule handling;while logistical staff were mostly injured by hollow needles and glass fragments from waste disposal.Nurses and doctors were the main injured groups,with a higher incidence among females(25-<35 years)and males(less than five years of work experience).The exposure source was mainly hepatitis B virus(HBV)infection.Post-ex-posure treatment was primarily standardized emergency treatment,but a higher proportion of non-standardized treatment was observed among logistics staff.Follow-up reports showed that interns and logistical staff had lower submission rates and lower training coverage.CONCLUSIONS Significant differences exist in sharps injury charac-teristics among medical staff in different positions.Attention should be paid to position-specific high-risk links and instruments.Targeted training and occupational health management should be strengthened to effectively prevent occupational exposure.

Objective:To study the intraoperative surgical factors which influenced non-immediate postoperative tracheal extubation (IPTE) after liver transplantation.Methods:The clinical data of all liver transplant recipients operated at the Qilu Hospital of Shandong University from January 2011 to July 2019 were reviewed. Patients who returned to a surgical ward with a tracheal cannula or who underwent re-intubation within 48 hours after IPTE because of hypoxemia were assigned to the cannula-preserving group (non-IPTE). The remaining liver recipients were assigned to the control group (IPTE). Univariate and multivariate logistic regression analysis were used to analyze the risk factors influencing IPTE.Results:Of 70 patients enrolled into this study, there were 30 patients in the cannula-preserving group (with 25 males, 5 females, and age of 51.8±7.3). And 40 patients in the control group (with 35 males, 5 females, and age of 48.4±9.6). Univariate logistic regression analysis showed anhepatic phase >45 min, blood loss >800 ml and intraoperative hypothermia were related with non-IPTE after liver transplantation(all P<0.05). Multivariate logistic regression analysis revealed anhepatic phase >45 min ( OR=3.972, 95% CI: 1.193-13.220, P=0.025) and intraoperative hypothermia ( OR=23.682, 95% CI: 2.434-230.438, P=0.006) increased the risk of unsuccessful IPTE. Conclusion:A long anhepatic phase and intraoperative hypothermia were surgical risk factors affecting non-IPTE after liver transplantation. Surgeons should avoid patients having hypothermia and a prolong anhepatic phase during liver transplantation.

OBJECTIVETo introduce the application and clinical effect of self-made liver fixing device in laparoscopic radical gastrectomy.

METHODSClinical data of 469 patients underwent laparoscopic radical gastrectomy in Nanfang Hospital, Southern Medical University from March 2014 to January 2017 were analyzed retrospectively. In laparoscopic radical gastrectomy, self-made liver fixing device was used to expose surgical field covered by hepatic lobe in gastric lesser curvature and hepatic flexure of colon. Manufacture of the self-made liver fixing device: appropriate length of the catheter was cut according to the size of liver; the lotus suture needle with a thread was put through two catheters to connect them. Then the prepared liver fixing device was sent into abdominal cavity through a 12-mm Trocar hole with needle holder and was fixed on the free hepatic lateral hepatogastric ligament with hemo-lock. Finally the application effect of the liver fixing device was evaluated by reviewing the surgical videos.

RESULTSA mean time of 40.3 seconds was required to complete liver fixing by using the self-made liver fixing device in laparoscopic radical gastrectomy and liver did not slip down in all the cases. Liver secondary manual fixing by assistants was 2 times averagely. Three cases had mild liver injury.

CONCLUSIONThe self-made liver fixing device in laparoscopic radical gastrectomy is easy to operate and can effectively expose sufficient surgical field, with high security and convenient materials.

Objective To evaluate hepatic segment vascular occlusion technology in precise resection of liver segment.Methods Sixty-seven cases of liver cancer patients who underwent precision liver segment resection from August 2007 to May 2012 in Qilu Hospital were analyszed retrospectively.There were 51 male patients and 16 female patients,age ranging from 45 to 66 yrs.Results All operations were performed successfully.All cases were with single tumor,the diameter ranged from 2 cm to 6 cm.Resection of segment Ⅲ was performed in 22 cases,segment Ⅳ in 10 cases and segment Ⅵ in 35 cases.Operation time was 50-120 minutes,and the average time was 73 minutes.Blood loss was 50-200 ml,averaging 86 ml.No patient needed blood transfusion.Postoperative incisional liquefaction was found in 6 cases which were cured with interference in time.There was no bile leakage,hemorrhage,celiac infection and complications such as liver failure.The average hospital stay was 7.8 days.No rccurrence was found during 3 months follow-up.Conclusions Hepatic segment vascular occlusion technology was safe and feasible in precise resection of liver segment in liver cancer patients.It effectively controlled blood loss and reduced liver damage.