Objective To evaluate the effectiveness of implementing precise management for Da Vinci robotic surgical consumables under the Diagnosis Related Group(DRG)payment system.Methods This retrospective case-control study ana-lyzed 200 patients undergoing Da Vinci robotic lung resection surgery in a tertiary hospital:100 cases from May to June 2022 as the control group,and 100 cases from May to June 2023 with implemented precision management as the observation group.The control group did not implement the payment according to DRG,while the observers implemented payment according to DRG and optimized refined management of Da Vinci robotic surgical consumables.Hospitalization duration,intraoperative costs,and utili-zation of high-value consumables were compared between the two groups.Results No statistically significant differences(P＞0.05)were observed between the two groups in terms of gender,age,medical insurance status,operative time,or intraoperative blood loss.The observation group exhibited a significantly shorter hospitalization duration(8.29±4.13 vs.10.47±4.57 days;P＜0.05),and higher surgical costs[(11 366.81±2 504.23)RMB vs.(8 716.07.78±256.34)RMB,P＜0.05]compared with the control group.Conclusion DRG-oriented precision management optimizes resource utilization through shortened hospi-talization time and rationalizes cost allocation,and sustainable consumable consumption patterns,demonstrating effective balance between clinical quality and economic efficiency under healthcare payment reforms.

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 evaluate the effectiveness of implementing precise management for Da Vinci robotic surgical consumables under the Diagnosis Related Group(DRG)payment system.Methods This retrospective case-control study ana-lyzed 200 patients undergoing Da Vinci robotic lung resection surgery in a tertiary hospital:100 cases from May to June 2022 as the control group,and 100 cases from May to June 2023 with implemented precision management as the observation group.The control group did not implement the payment according to DRG,while the observers implemented payment according to DRG and optimized refined management of Da Vinci robotic surgical consumables.Hospitalization duration,intraoperative costs,and utili-zation of high-value consumables were compared between the two groups.Results No statistically significant differences(P＞0.05)were observed between the two groups in terms of gender,age,medical insurance status,operative time,or intraoperative blood loss.The observation group exhibited a significantly shorter hospitalization duration(8.29±4.13 vs.10.47±4.57 days;P＜0.05),and higher surgical costs[(11 366.81±2 504.23)RMB vs.(8 716.07.78±256.34)RMB,P＜0.05]compared with the control group.Conclusion DRG-oriented precision management optimizes resource utilization through shortened hospi-talization time and rationalizes cost allocation,and sustainable consumable consumption patterns,demonstrating effective balance between clinical quality and economic efficiency under healthcare payment reforms.

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 analyze the status quo and hot topics in research on venous thromboembolism (VTE) prevention during the perioperative period and provide references for future research and clinical practice.Methods:Journal articles related to perioperative VTE prevention were retrieved from the Web of Science Core Collection database up to June 30, 2023. Bibliometric analysis was conducted using CiteSpace 6.2.R4.Results:A total of 1 079 articles were included, showing an overall upward trend in the publication volume of perioperative VTE prevention research from 1999 to 2023. Research themes mainly focused on high-risk populations for VTE, high-risk types of surgery, risk factors and assessment, perioperative prevention, and nursing care. Current hot topics include "risk assessment" "anticoagulation therapy" "guidelines" "aspirin" and "rivaroxaban".Conclusions:Perioperative VTE prevention has increasingly garnered the attention of medical and nursing professionals. Future efforts should emphasize international exchange and cooperation to explore strategies for VTE prevention at different stages of the perioperative period and leverage information technology to enhance the quality of perioperative VTE prevention and management.

The core competencies of Operating Room specialist nurses are the key to being competent in Operating Room nursing work. However, the core competencies that Operating Room specialist nurses should possess in China are not yet clear, and there is no unified and standardized training model. This paper summarizes the concepts, core competency standards, and training models of Operating Room specialist nurses, explores the existing problems in admission conditions, curriculum arrangement, training content, training methods, and assessment of Operating Room specialist nurses, and puts forward suggestions for the training of Operating Room specialist nurses in China, in order to promote the improvement of core competency of Operating Room specialist nurses and the homogenization and standardization of training models.

According to the literature and expert experience, a comprehensive index system of subjective and objective was established, including the patient's condition, the treatment information for the same kind of patients, technical level of the medical team, and the medical conditions. Secondly, in the light of the heterogeneous evaluation information, the comprehensive index weight was computed by combining subjective weight and objective entropy weight. Furthermore, the VIKOR method was applied to deal with heterogeneous evaluation information and obtain the priority of potential surgical treatments. Taking a rectal cancer patient in a general hospital in Hunan Province as an example, the optimal surgical treatment obtained by this method was consistent with the actual treatment. The reliability and effectiveness of the heterogeneous VIKOR method based on probabilistic linguistic term sets are verified by an experimental example of rectal cancer, and the method can be used to help doctors, patients and family members to select the surgical treatments for rectal cancer effectively.
Body Weight ; Humans ; Rectal Neoplasms ; surgery ; Reproducibility of Results

PURPOSE: Rituximab with cyclophosphamide, doxorubicin, vincristine, and prednisone administered every 3 weeks (R-CHOP-21) is the standard care for diffuse large B-cell lymphoma (DLBCL). It is unknown whether the dose-dense R-CHOP (R-CHOP-14) could improve the outcome of the disease in Asian population. MATERIALS AND METHODS: Newly diagnosed DLBCL patients were centrally, randomly assigned (1:1) to receive R-CHOP-14 or R-CHOP-21. R-CHOP-14 was administered every 2 weeks, and R-CHOP-21 was administered every 3 weeks. Primary end point was disease-free survival (DFS). Secondary end points included overall survival (OS), progression-free survival (PFS), response rate and toxicities. RESULTS: Seven hundred and two patients were randomly assigned to receive R-CHOP-14 (n=349) or R-CHOP-21 (n=353). With a median follow-up of 45.6 months, the two groups did not differ significantly in 3-year DFS (79.6% for R-CHOP-14 vs. 83.2% for R-CHOP-21, p=0.311), 3-year OS (77.5% for R-CHOP-14 vs. 77.6% for R-CHOP-21, p=0.903), or 3-year PFS (63.2% for R-CHOP-14 vs. 66.1% for R-CHOP-21, p=0.447). Patients with an International Prognostic Index (IPI) score ≥ 2 had a poorer prognosis compared to those with an IPI score < 2. Grade 3/4 hematologic and non-hematologic toxicities were manageable and similar between R-CHOP-14 and R-CHOP-21. CONCLUSION: R-CHOP-14 did not improve the outcome of DLBCL compared to R-CHOP-21 in Asian population. With manageable and similar toxicities, both of the two regimens were suitable for Asian DLBCL patients. For high-risk patients with IPI ≥ 2, new combination regimens based on R-CHOP deserve further investigation to improve efficacy.
Asian Continental Ancestry Group ; B-Lymphocytes ; Cyclophosphamide ; Disease-Free Survival ; Doxorubicin ; Follow-Up Studies ; Humans ; Lymphoma, B-Cell ; Prednisone ; Prognosis ; Rituximab ; Vincristine

OBJECTIVE To investigate the correlation between vascular endothelial function and aortic compliance in patients with obstructive sleep apnea hypopnea syndrome(OSAHS) and hypertension. METHODS A total of 103 OSAHS cases were divided into simple OSAHS group(n=55) and OSAHS complicated with hypertension group(n=48, OSAHS+HT group). 20 patients with simple hypertension were included into the hypertension group, and 20 healthy people served as controls. Vascular endothelial function was evaluated by detecting flow mediated dilation of the brachial artery(FMD) with color Doppler; the changes of aortic compliance in patients were detected by echocardiography. RESULTS The FMD, aortic tension and aortic distensibility index levels of OSAHS with hypertension group were significantly lower than the normal control group, hypertension group and OSAHS group(P<0.05); The aortic stiffness index level of OSAHS hypertension group was significantly higher than the normal group, the high blood pressure group and OSAHS group(P<0.05); Analysis of Spearman correlation coefficient of patients in OSAHS with hypertension group found aortic FMD were positively correlated with aortic stiffness index, negatively correlated with aortic tension index and aortic expansion; The aortic FMD, aortic tension, swelling index and aortic stiffness index in OSAHS hypertension group had positive correlation with AHI (P<0.05), and negative correlation with LSaO2(P<0.05). CONCLUSION OSAHS is associated with vascular endothelial dysfunction and decreased aortic compliance. When combined with hypertension, vascular endothelial function and aortic compliance will be significantly affected. The severity of OSAHS was closely related to the decrease of vascular endothelial function and the changes of aortic compliance.

Background and purpose:Majority of patients with B cell lymphoma often achieve complete clinical remission after systemic treatment, but half of the patients ultimately relapse. The residual neoplastic cells, commonly called ‘minimal residual disease’ (MRD), are thought to be the source of relapse. But not all of the patients whose results of IgH rearrangement were positive had relapse or distant involvement. It was thought that the patients whose IgH rearrangement was positive relapsed or not may be associated with the quantity of IgH rearrangement. The study tried to investigate the feasibility and clinical significance of detecting immunoglobulin heavy chain gene in DLBCL by SYBR Green RT-FQ-PCR. Methods:Fifty-seven bone marrow specimens from 44 patients diagnosed with DLBCL were used to detect IgH-R. Namalwa cell line and U-937 cell line were used for positive and negative control respectively. The ?-actin gene was chosen as inter control. DNA was isolated by phenol-chloroform-isoamyl alcohol and then was amplified by SYBR Green RT-FQ-PCR targeting the IgH-R CDR Ⅲ.Results:Melting curve analysis could confirm the specificity of IgH-R. The positive rate detected by RT-FQ-PCR was 63.2%. The positive results of IgH/?-actin were between 0.01 and 4131.69, and the median was 0.42. There was a significant difference between stage Ⅰ/Ⅱ and stage Ⅲ/Ⅳ in IgH-R quantity (P=0.018). Nonparametric test showed that there was a significant difference between patients with normal LDH and patients with elevated LDH (P=0.046).Conclusions:SYBR Green RT-FQ-PCR is a valuable, feasible and sensitive tool to detect IgH rearrangement in DLBCL. Detecting IgH-R using RT-FQ-PCR can help staging more accurately.