Objective:To investigate the short-term clinical efficacy of two fixation methods, mini-titanium plate fixation and suture suspension, in cervical posterior unilateral laminoplasty, and to explore the relationship between changes in the cervical sagittal sequence and therapeutic outcomes.Methods:A retrospective analysis was conducted on 55 patients who underwent cervical posterior unilateral laminoplasty with mini-titanium plate fixation and 50 patients with suture suspension at the First People's Hospital of Lianyungang from September 2020 to January 2023. All patients were followed up for 12 months, and the axial symptoms was recorded. The main clinical efficacy evaluations included before surgery and 12 months after surgery visual analog score (VAS) for neck pain, Japanese Orthopaedic Association score (JOA) and neck disability index (NDI). Four parameters were recorded before surgery and 12 months after surgery to assess the sagittal sequence: C 2-7 sagittal vertical axis (C 2-7SVA), T 1 slope angle (T 1s), C 2-7Cobb angle and cervical range of motion. Results:The mini-titanium plate fixation group had 5 cases of axial symptoms, while the traditional suture suspension group had 16 cases; the postoperative VAS, JOA and C 2-7Cobb angle in the mini-titanium plate fixation group were all less than those in the suture suspension group, with statistically significant differences ( P<0.05). Specifically, the postoperative VAS in the mini-titanium plate fixation group was (1.93 ± 1.42) points, and (2.67 ± 2.15) points in the suture suspension group ( P = 0.049); the JOA was (10.39 ± 2.20) points in the mini-titanium plate fixation group and (9.62 ± 1.52) points in the suture suspension group ( P = 0.012); the C 2-7Cobb angle was (21.087 ± 3.564)° in the mini-titanium plate fixation group and (23.092 ± 1.265)° in the suture suspension group ( P = 0.003). There was no statistical difference in operation time and blood loss between two groups ( P>0.05). The postoperative C 2-7SVA, T 1s and range of motion in the traditional suture suspension group were less than those in the mini-titanium plate fixation group, with statistically significant differences ( P<0.05). Specifically, the postoperative C 2-7SVA was (25.700 ± 3.035) mm in the mini-titanium plate fixation group and (23.946 ± 3.079) mm in the suture suspension group ( P = 0.004); the postoperative T 1s was (28.770 ± 2.361)° in the mini-titanium plate fixation group and (26.746 ± 3.198)° in the suture suspension group ( P = 0.004); the postoperative range of motion was (32.651 ± 4.995)° in the mini-titanium plate fixation group and (28.672 ± 5.874)° in the suture suspension group ( P = 0.003). Conclusions:Cervical posterior unilateral laminoplasty with mini-titanium plate fixation can effectively improve VAS, JOA, and restore neurological function, maintaining the cervical spine's sagittal balance, stability, and maximum range of motion.

Objective:To investigate the short-term clinical efficacy of two fixation methods, mini-titanium plate fixation and suture suspension, in cervical posterior unilateral laminoplasty, and to explore the relationship between changes in the cervical sagittal sequence and therapeutic outcomes.Methods:A retrospective analysis was conducted on 55 patients who underwent cervical posterior unilateral laminoplasty with mini-titanium plate fixation and 50 patients with suture suspension at the First People's Hospital of Lianyungang from September 2020 to January 2023. All patients were followed up for 12 months, and the axial symptoms was recorded. The main clinical efficacy evaluations included before surgery and 12 months after surgery visual analog score (VAS) for neck pain, Japanese Orthopaedic Association score (JOA) and neck disability index (NDI). Four parameters were recorded before surgery and 12 months after surgery to assess the sagittal sequence: C 2-7 sagittal vertical axis (C 2-7SVA), T 1 slope angle (T 1s), C 2-7Cobb angle and cervical range of motion. Results:The mini-titanium plate fixation group had 5 cases of axial symptoms, while the traditional suture suspension group had 16 cases; the postoperative VAS, JOA and C 2-7Cobb angle in the mini-titanium plate fixation group were all less than those in the suture suspension group, with statistically significant differences ( P<0.05). Specifically, the postoperative VAS in the mini-titanium plate fixation group was (1.93 ± 1.42) points, and (2.67 ± 2.15) points in the suture suspension group ( P = 0.049); the JOA was (10.39 ± 2.20) points in the mini-titanium plate fixation group and (9.62 ± 1.52) points in the suture suspension group ( P = 0.012); the C 2-7Cobb angle was (21.087 ± 3.564)° in the mini-titanium plate fixation group and (23.092 ± 1.265)° in the suture suspension group ( P = 0.003). There was no statistical difference in operation time and blood loss between two groups ( P>0.05). The postoperative C 2-7SVA, T 1s and range of motion in the traditional suture suspension group were less than those in the mini-titanium plate fixation group, with statistically significant differences ( P<0.05). Specifically, the postoperative C 2-7SVA was (25.700 ± 3.035) mm in the mini-titanium plate fixation group and (23.946 ± 3.079) mm in the suture suspension group ( P = 0.004); the postoperative T 1s was (28.770 ± 2.361)° in the mini-titanium plate fixation group and (26.746 ± 3.198)° in the suture suspension group ( P = 0.004); the postoperative range of motion was (32.651 ± 4.995)° in the mini-titanium plate fixation group and (28.672 ± 5.874)° in the suture suspension group ( P = 0.003). Conclusions:Cervical posterior unilateral laminoplasty with mini-titanium plate fixation can effectively improve VAS, JOA, and restore neurological function, maintaining the cervical spine's sagittal balance, stability, and maximum range of motion.

Objective:To Summarize the best evidence of follow-up management of patients with acute kidney injury to provide reference for clinical nursing work.Methods:Retrieved relevant literature on follow-up management of ICU transferred acute kidney injury patients from databases such as Cochrane Library, PubMed, CNKI, Wanfang Database, Chinese Biomedical Literature, and related professional websites based on the "6S" model system.The search deadline was from database establishment to May 30, 2023.Two researchers independently conducted literature quality evaluation, evidence screening, and evidence level assessment, and summarized the evidence.Results:Eight articles were selected, including 4 guidelines, 3 systematic review, 1 expert consensuses. Finally 16 pieces of best evidence from 6 dimensions of follow-up principles and methods, follow-up time/requency, follow- up assessment content, nutritional guidance, drug guidance and life guidance.Conclusions:This study summarized the best evidence summary of the follow-up management of patients with ICU transfer out of acute kidney dormitory, providing a reference for the clinical work of ICU medical staff. Medical staff can develop scientific and effective follow-up management based on patients and clinical conditions to improve the quality of care for ICU transferred patients.

OBJECTIVE To compare the changes of chemical components of Morus alba leaves， screen differential markers， and determine their contents， so as to provide reference for quality control of M. alba leaves before and after baked with honey. METHODS The fingerprints of M. alba leaves before and after baked with honey were established by high-performance liquid chromatography （HPLC）. The common peaks of the fingerprints were identified and the similarity was evaluated. The differential markers of M. alba leaves before and after baked with honey were screened by principal component analysis （PCA） and orthogonal partial least squares-discriminant analysis （OPLS-DA） using common peak are of raw material and product baked with honey of M. alba leaves as index. The quantitative analysis was carried out. RESULTS Twenty-three and twenty-four common peaks were identified from the HPLC fingerprint spectra of ten batches of raw material and ten batches of product baked with honey of M. alba leaves， respectively. The similarities of HPLC fingerprints for raw material and product baked with honey of M. alba leaves were all greater than 0.97. The results of PCA showed that raw material and product baked with honey of M. alba leaves could be divided into two categories. The results of OPLS-DA showed that the variable importance in projection of peak 2， peak H （5- hydroxymethylfurfural）， peak 1， peak 17 （isochlorogenic acid C） and peak 16 were all greater than 1. The average contents of differential marker of isochlorogenic acid C in raw material and product baked with honey of M. alba leaves were 0.093 6 and 0.127 8 mg/g， respectively； there was statistical significance （P＜0.05）. CONCLUSIONS Five differential markers such as isochlorogenic acid C are obtained. The content of isochlorogenic acid C in M. alba leaves is significantly increased after baked with honey.

Objective:To analyze the application effect of intelligent acceptance equipment for orthopedic medical equipment combined with medical device unique device identifier(UDI)code in the management of orthopedic medical devices.Methods:Based on the UDI code,the UDI application process of orthopedic medical devices was formulated,and all operations such as inspection and accurate billing of orthopedic medical devices were completed through the identification and comparison of intelligent acceptance equipment for orthopedic medical devices.A total of 8 317 orthopedic instruments used in orthopedic surgery in Wangjing Hospital of China Academy of Chinese Medical Sciences from September to December 2023 were selected.According to the different time of the implementation of intelligent acceptance equipment for orthopedic medical devices,the 4 072 orthopedic devices used from September to October 2023 was marked as before implementation and adopted the traditional management mode,the 4 245 orthopedic devices used from November 2023 to December 2023 were marked as before implementation and adopted the intelligent acceptance management mode.The management effect and incidence of adverse events were compared before and after the implementation of intelligent acceptance equipment for orthopedic medical devices.Results:The total effective rate of management after the implementation of intelligent acceptance equipment for orthopedic medical instruments was 98.78%,which was significantly higher than that before the implementation,the difference was statistically significant(x2=272.03,P<0.01).The total incidence of adverse events after the implementation of the intelligent acceptance equipment for orthopedic medical devices was 8.83%,which was significantly lower than that before the implementation,the difference was statistically significant(x2=281.38,P<0.01).Conclusion:The intelligent acceptance device combined with UDI code for orthopedic medical devices can achieve efficient distribution,accurate acceptance and billing,reduce the occurrence of adverse events,meet the requirements of the whole process traceability management of one thing and one code,and improve the management level orthopedic medical devices.

OBJECTIVE To establish the fingerprint of the ethanol extract from Callicarpa nudiflora， analyze its anti- respiratory syncytial virus （RSV） activity in vitro， and study the relationship between spectrum and effect. METHODS Using 10%， 30%， 50%， 70% and 90% ethanol as solvent， 20 batches of ethanol extracts from 4 batches of C. nudiflora were prepared. The fingerprints for 20 batches of ethanol extracts from C. nudiflora were mapped by ultra-high-performance liquid chromatography （UPLC）， and the similarity evaluation was conducted by using the Similarity Evaluation System for Traditional Chinese Medicine Chromatographic Fingerprints （2012 edition）. The cytopathic effect method and MTT method were used to investigate the in vitro inhibitory activity of the ethanol extracts from C. nudiflora on RSV. Pearson correlation analysis， grey correlation degree and orthogonal partial least squares （OPLS） analysis were used to study the spectrum-effect relationship. RESULTS There were 25 common peaks in 20 batches of ethanol extracts from C. nudiflora， and the similarities ranged from 0.912 to 0.998， and the RSDs of common peak areas were 33.54%-162.28%. The average values of IC50 for RSV of 20 batches of ethanol extracts from C. nudiflora were 9.55-272.23 μg/mL. The results of Pearson correlation analysis， grey correlation analysis and OPLS analysis showed that the Pearson correlation coefficients （P＜0.05） of the common peaks 8， 10， 12， 16， 18-19， 22-24 with pharmacodynamic indicators and regression coefficients were all negative， the correlation coefficients were all greater than 0.6， and the values of variable importance in projection were all greater than 1. CONCLUSIONS Twenty batches of ethanol extracts from C. nudiflora have similar components but significant differences in content， and exhibit different degrees of anti-RSV activity in vitro. The corresponding components of common peaks 8， 10， 12， 16， 18-19， 22-24 may be the characteristic components of anti-RSV of C. nudiflora.

Objective:To construct follow-up index system of ICU patients with acute kidney injury based on the Omaha nursing outcome classification system, and to provide a reference for the clinical care quality and the follow-up work of ICU patients after discharge.Methods:Based on the Omaha nursing outcome classification system, the Delphi method was used to establish the content of the follow-up index system for ICU patients with acute kidney injury, and determine the weight of all levels of indicators.Results:After two rounds of expert consultation, questionnaire response rates were 95.00%and 100.00%, expert authority coefficients were 0.861 and 0.892 (both P<0.01), coordination coefficients ranged from 0.296 to 0.667 and 0.240 to 0.804, the difference were statistically significant ( χ2 values were 60.77-288.17, and P<0.01). The final index system consisted of 4 first-level indicators, 16 second-level indicators, and 52 third-level indicators. The analytic hierarchy process was used to determine the weights of all indexes, and the consistency test (consistency ratio<0.1) was performed. Conclusions:The follow-up index system of ICU patients with acute kidney injury was constructed to provide a reference for the clinical care quality and the follow-up work of ICU patients after discharge, and to provide a theoretical basis for the follow-up mode after ICU.

Objective:To summarise the experience in use of sural neurouascular flap in repair of the soft tissue defects of foot and ankle, and explore the methods in promoting the survival and appearance of the flap.Methods:Data of 10 patients who underwent sural neurocutaneous flap surgery for repairing soft tissue defects in the foot and ankle in the Department of Foot and Ankle of Xuzhou Renci Hospital from October 2019 to June 2020 were retrospectively analysed. Among the 10 patients, 8 were males and 2 were females, and the age ranged from 18 to 54 years old, with an average age of 42.5 years old; Causes of injury: 8 patients injured by traffic accident and 2 by incision necrosis after calcaneal fracture operation. The areas of soft tissue defect were 4.0 cm×6.0 cm-16.0 cm×10.0 cm. Sural neurouascular flap was used for the defect repairs. Method of optimisation: ①The small saphenous vein in the flap was separated and retained in the limb to optimise the venous circulation. ②Freed peroneal perforator vessels that entered the pedicle, and made the point where the vessels entering the pedicle as the rotation point. The pedicle contained the sural neurovascular bundle, the main trunk of the small saphenous vein and the fascia tissue, with a width about 2.0 cm. It not only increased the blood supply of the flaps, but also a good appearance of the pedicle. ③ The torsion of the pedicle was covered by an arc-shaped flap and transferred through an open channel to prevent compression. ④The donor site was covered with relay flap. According to the location of the donor site, a proximal peroneal artery perforator flap or medial and lateral sural artery perforator flap was selected. ⑤Sural nerve was anastomosed with the peripheral sensory nerve in some cases. The survival of the flap, Maryland Foot Function Score and British Medical Research Council (BMRC) sensory function evaluation were investigated in the follow-up to evaluate the functional recovery of the flap and limb.Results:All the 10 patients received the follow-up for 6 to 12 months, with an average of 8.5 months. The donor and recipient flaps survived completely with good appearance in lower limb, good soft texture, good elasticity and wear resistance. The sensation of the flap with nerve anastomosis in 3 cases was evaluated according to BMRC, and they achieved sensation recovery up to level of S 3 or above. The patients had great satisfactions. At the last follow-up, the curative efficacy was evaluated according to the Maryland scoring system. It ranged from 85 to 98 points, with an average of 91.6 point, 8 patients in excellent and 2 in good. Conclusion:Sural neurouascular flap can achieve a sufficient blood supply, a reasonable venous circulation and a high survival rate. The donor site was covered with relay flap to obtain a good appearance, and the anastomosed sensory nerve offered a good sensation. The function of foot and ankle recovered well, and the clinical effect was satisfactory.

Objective:To summarize the evidence of diet management in patients with chronic kidney disease (CKD) in stage 3-5 D, so as to provide a reference for clinical nursing.Methods:After establishing evidence-based nursing questions, according to the "6S evidence model", the evidence on diet management of patients with CKD in stage 3-5 D was searched by computer, including computer decision support system evidence, guidelines, best evidence summary and systematic review. The search time limit was from the establishment of the database to September 2020. The guideline quality assessment was independently completed by two research nurses and a doctor of nephrology. The quality assessment of non-guideline article was independently completed by two research nurses, and an evidence-based instructor participated in decision-making. The evidence was extracted, evaluated and graded using the Joanna Briggs Institute (JBI) 2014 version of the intervention research evidence pre-grading system.Results:A total of 19 articles that met the requirements were included, including 5 guidelines, 8 systematic reviews, 4 randomized controlled trials, 1 clinical decision, and 1 national standard. A total of 22 pieces of the best evidence on diet management of patients with CKD in stage 3-5 D were summarized from three aspects, namely, diet/nutrition assessment, diet management, teamwork and education.Conclusions:The best evidence of diet management in patients with CKD in stage 3-5 D provides a certain reference for clinical practice, so as to improve the quality of diet management in patients with CKD and the clinical outcomes of patients.

Objective:To evaluate the quality of relevant practice guidelines for the prevention of surgical site infections in adult inpatients and provide a reference for formulating protocols to prevent surgical site infections in adults.Methods:Practice guidelines related to the prevention of surgical site infections in adults published up to June 2, 2020 were retrieved from domestic and foreign databases, guideline websites and the websites of professional societies. The Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ) was used to evaluate the methodological quality of the included guidelines, and the intra-group correlation coefficient was used to test the consistency between the reviewers.Results:A total of 6 clinical practice guidelines were included, and in terms of the quality, there were 4 grade A guidelines and 2 grade B guidelines. The average standardized scores of AGREE Ⅱ in 6 dimensions were: 87.04% for scope and purpose, 76.62% for stakeholder involvement, 76.56% for rigor of development, 89.58% for clarity of presentations, 81.60% for applicability, and 81.25% for independence.Conclusions:The existing clinical practice guidelines related to the prevention of surgical site infections in adults are relatively comprehensive with a relatively good quality. Nursing staff need to consider the applicability of evidence application, formulate practical infection prevention strategies, and reduce the incidence of surgical site infections in adults.