Objective:To evaluate the effects of a reduced-positioning restrictions nursing program on postoperative recovery, sleep quality, self-care ability, and hip joint function in patients undergoing total hip arthroplasty (THA), providing a reference for postoperative positioning management.Methods:A randomized controlled trial was conducted, and 140 THA patients admitted to Zhejiang Provincial People′s Hospital from January 2022 to June 2023 were selected using convenience sampling. They were divided into a control group (70 cases) and an observation group (70 cases) using a random number table. The control group received conventional rehabilitation care, while the observation group received a reduced-positioning restrictions nursing program in addition to the conventional care. The incidence of dislocation at 3 months postoperatively, the activities of daily living, the hip joint function recovery at 1 month and 3 months postoperatively, the sleep quality at 1 month postoperatively were compared between the two groups.Results:Finally 63 cases in the control group and 64 cases in the observation group completed the study. The control group included 25 males and 38 females, with an average age of (65.44 ± 10.97) years, while the observation group included 28 males and 36 females, with an average age of (65.13 ± 12.18) years. At 3 months postoperatively, there was no significant difference in the dislocation rate between the control group and the observation group ( P>0.05). At 1 month and 3 months postoperatively, the scores of activities of daily living in the observation group were (77.89 ± 6.71) and (93.52 ± 6.59) points respectively, which were higher than those in the control group [(69.68 ± 5.53) and (87.38 ± 7.72) points], the differences were statistically significant ( t=5.38, 6.96, both P<0.05), the time, interaction and inter-group effects were all statistically significant ( F=33.93, 10.81, 876.91, all P<0.05). At 1 month postoperatively, the excellent and good rate of hip joint function score grade in the observation group was 73.44% (47/64), which was higher than 41.27% (26/63) in the control group, the difference was statistically significant ( Z=-3.67, P<0.05), there was no statistically significant difference between the two groups at 3 months postoperatively ( P>0.05). At 1 month after the operation, the excellent and good rate of sleep quality score grades in the observation group was 81.25% (52/64), which was higher than 57.14% (36/63) in the control group, and the difference was statistically significant ( Z=-3.00, P<0.05). Conclusions:Incorporating a reduced-positioning restrictions nursing program into the perioperative management of THA does not increase the risk of prosthesis dislocation. This approach enhances patient comfort, improves sleep quality, increases self-care ability, and supports the recovery of hip joint function.

Objective:To evaluate the effects of a reduced-positioning restrictions nursing program on postoperative recovery, sleep quality, self-care ability, and hip joint function in patients undergoing total hip arthroplasty (THA), providing a reference for postoperative positioning management.Methods:A randomized controlled trial was conducted, and 140 THA patients admitted to Zhejiang Provincial People′s Hospital from January 2022 to June 2023 were selected using convenience sampling. They were divided into a control group (70 cases) and an observation group (70 cases) using a random number table. The control group received conventional rehabilitation care, while the observation group received a reduced-positioning restrictions nursing program in addition to the conventional care. The incidence of dislocation at 3 months postoperatively, the activities of daily living, the hip joint function recovery at 1 month and 3 months postoperatively, the sleep quality at 1 month postoperatively were compared between the two groups.Results:Finally 63 cases in the control group and 64 cases in the observation group completed the study. The control group included 25 males and 38 females, with an average age of (65.44 ± 10.97) years, while the observation group included 28 males and 36 females, with an average age of (65.13 ± 12.18) years. At 3 months postoperatively, there was no significant difference in the dislocation rate between the control group and the observation group ( P>0.05). At 1 month and 3 months postoperatively, the scores of activities of daily living in the observation group were (77.89 ± 6.71) and (93.52 ± 6.59) points respectively, which were higher than those in the control group [(69.68 ± 5.53) and (87.38 ± 7.72) points], the differences were statistically significant ( t=5.38, 6.96, both P<0.05), the time, interaction and inter-group effects were all statistically significant ( F=33.93, 10.81, 876.91, all P<0.05). At 1 month postoperatively, the excellent and good rate of hip joint function score grade in the observation group was 73.44% (47/64), which was higher than 41.27% (26/63) in the control group, the difference was statistically significant ( Z=-3.67, P<0.05), there was no statistically significant difference between the two groups at 3 months postoperatively ( P>0.05). At 1 month after the operation, the excellent and good rate of sleep quality score grades in the observation group was 81.25% (52/64), which was higher than 57.14% (36/63) in the control group, and the difference was statistically significant ( Z=-3.00, P<0.05). Conclusions:Incorporating a reduced-positioning restrictions nursing program into the perioperative management of THA does not increase the risk of prosthesis dislocation. This approach enhances patient comfort, improves sleep quality, increases self-care ability, and supports the recovery of hip joint function.

Objective:To evaluate and summarize the evidence on postoperative exercise in patients with rotator cuff injury, so as to provide a basis for guiding the postoperative exercise in patients with rotator cuff injury.Methods:We searched the Joanna Briggs Institute (JBI) Evidence-Based Health Care Center Database, British Medical Journal (BMJ) Best Practice, UpToData, China Biomedical Literature Database, WanFang Data, China National Knowledge Infrastructure, and other databases on postoperative exercise in patients with rotator cuff injury, including guidelines, evidence summaries, systematic reviews, best practice information books, clinical decision-making, recommended practices, and expert consensus. The retrieval period was from the establishment of the database to June 4, 2022.Results:A total of 30 articles were included, including one guideline, one evidence summary, one clinical decision-making, two expert consensuses, and 25 systematic reviews. 22 pieces of evidence from 12 aspects were summarized, including applicable population, exercise benefit, exercise risk, exercise assessment, exercise program, exercise method, exercise time, exercise intensity, exercise monitoring, formulation principles, management mode, and health education were summarized.Conclusions:The evidence summary process is scientific, rigorous, and comprehensive in content. In the process of evidence transformation, medical and nursing staff should select the best evidence according to specific situations and individual patient factors, so as to guide patients with rotator cuff injury to exercise safely and effectively after surgery to improve clinical outcomes.

With the transition from quantity-centric healthcare to value-centric healthcare, patient-reported outcome plays an important role in healthcare. Patient-reported outcome is an effective method for evaluating the outcome of hip replacement patients. It can be used not only in science research, but also in clinical practice and medical care quality assessment. This article reviews the patient-reported outcome measures in hip replacement, so as to provide references for clinical practice and research of clinical medical and nursing staff to accurately select appropriate patient-reported outcome measures in hip replacement.

Objective:To systematically analyze and evaluate the bleeding risk prediction model of patients with venous thromboembolism (VTE) , so as to provide a reference for nursing practice.Methods:PubMed, Web of Science, Embase, Cochrane Library, Wiley Online Library, CINAHL, Scopus, ProQuest, Clinicalkey, Wanfang, China National Knowledge Infrastructure, VIP databases were searched for bleeding risk prediction model of VTE patients. The retrieval time was from the establishment of the databases to August 19, 2021. Two researchers independently screened the literature according to the inclusion and exclusion criteria, then extracted the data and evaluated the quality of the literature.Results:Ten relevant literatures were included in this study, including 4 retrospective studies and 6 prospective studies. The area under the receiver operating characteristic curve of one model was greater than 0.7, and the C-index of four models were greater than 0.7. The prediction model contained many relevant factors, including bleeding history, age, anemia, tumor, antiplatelet therapy, gender, renal insufficiency, etc. In the evaluation of risk of bias and applicability, 10 studies had good applicability, but there were bias mainly due to insufficient number of events in the dependent variable, conversion of continuous variables into dichotomous variables and missing data were not reported. Conclusions:The research on the prediction model of bleeding risk in VTE patients is still in the development stage. In the future, risk prediction models with excellent performance in all aspects and low risk of bias can be developed and verified externally.

Objective:To analyze the clinical phenotype and molecular pathogenesis of nine patients with hereditary factor Ⅴ (FⅤ) deficiency.Methods:Nine patients with hereditary FⅤ deficiency who were admitted to the Institute of Hematology and Blood Diseases Hospital from April 1999 to September 2019 were analyzed. The activated partial thromboplastin time, prothrombin time, and FⅤ procoagulant activity (FⅤ∶C) were measured for phenotypic diagnosis. High-throughput sequencing was employed for the F5 gene mutation screening, Sanger sequencing was adopted to confirm candidate variants and parental carrying status, Swiss-model was used for three-dimensional structure analysis, and ClustalX v.2.1 was used for homologous analysis.Results:The FⅤ∶C of the nine patients ranged from 0.1 to 10.6. Among them, eight had a hemorrhage history, with kin/mucosal bleeding as the most common symptom (three cases, 37.5%) , whereas one case had no bleeding symptom. There were five homozygotes and four compound heterozygotes. A total of 12 pathogenic or likely pathogenic mutations were detected, of which c.6100C>A/p.Pro2034Thr, c.6575T>C/p.Phe2192Ser, c.1600_1601delinsTG/p. Gln534*, c.4713C>A/p.Tyr1571*, and c.952+5G>C were reported for the first time.Conclusion:The newly discovered gene mutations enriched the F5 gene mutation spectrum associated with hereditary FⅤ deficiency. High-throughput sequencing could be an effective method to detect F5 gene mutations.

Objective? To explore the effect of multi-mode interactive continuous nursing on home rehabilitation and complications of patients after total hip arthroplasty(THA). Methods? From January 2017 to July 2018, patients undergoing THA in Zhejiang Provincial People's Hospital were selected by purposive sampling method. They were randomly divided into two groups according to visit numbers. There were 43 effective cases in the control group and 42 in the observation group. The control group adopted the traditional telephone follow-up mode, while the observation group adopted the multi-mode interactive continuous nursing intervention. The Modified Barthel Index(MBI), Harris Hip Score(HHS) and 6-Minute Walking Tes(t 6MWT) were used to compare the rehabilitation effects of the two groups at discharge, 1, 3 and 6 months after operation, and the complications, unplanned hospital visits and hospitalizations of the two groups were compared. Results? There was no significant difference in each index between the two groups at discharge (P＞ 0.05). The scores of MBI in the observation group were (78.57±7.43), (90.36±7.76), (94.41±7.51) respectively at 1, 3 and 6 months after operation, which were higher than those in the control group [(70.35±7.60), (82.40±7.82), (91.86±8.80)], and there were significant differences between the two groups at 1 and 3 months after operation (P＜ 0.05). The scores of HHS in the observation group were (82.05±7.40), (87.52±6.94), (91.17±7.40) respectively, higher than those in the control group (78.40±7.51), (84.09±7.23), (88.37±8.46), there were significant differences between the two groups at 1 and 3 months after operation (P＜ 0.05). The distance of 6MWT in the observation group were (174.76±35.04)m, (241.55±40.67)m, (282.86±46.46) m, higher than those in the control group (151.61±42.52)m, (214.42±48.59)m, (260.35±48.05) m. There were significantly statistical differences in the 1, 3 and 6 months after operation (P＜0.05). In the observation group, there were 1 case of fracture, 9 cases of unplanned hospital visit or hospitalization, 2 cases of dislocation, 1 case of infection and 20 cases of unplanned hospital visit or hospitalization in the control group. Conclusions? Continuous nursing with multi-mode interaction can improve the effect of home rehabilitation after THA, effectively improve the early and long-term hip function of patients, prevent and reduce complications, and improve the quality of life of patients.

Objective To explore the effect and safety of ice compress combined with early walking training on postoperative rehabilitation in patients with total hip arthroplasty (THA) without drainage. Methods Totally 84 THA patients from Zhejiang Provincial People′s Hospital were recruited in this study during April 2015 to March 2016 by using purposive sampling method. According to the random number table (i.e. hospital ID),the participants were divided into the intervention group (n=42) and the control group (n=42). Patients in the control group received drainage tubes after THA,and started walking training after removing the tubes. However,patients in the intervention group didn′t receive drainage tubes after THA but received ice compress,and started walking training within 24 hours after surgery. The postoperative complications,the pain, swelling degree,hemoglobin change,time of recoving independent walking,activities of daily living (ADL),and average inpatient days of patients in two groups were observed and compared.Results The pain scores within 24 hours and 25-48 hours after surgery for the intervention group were (2.38±1.13) and (1.90±1.06),which were lower than the scores [(3.26±1.38) and (2.41±1.0)] for the control group (t=3.283,2.487;P<0.05). But the pain scores 49-72 hours after surgery had no statistical differences between two groups (t=-1.185;P>0.05). Similarly,there were no differences between two groups in wound swelling and hemoglobin change (t=-1.221,-0.294;P>0.05). The ADL scores one week and two weeks after THA surgery for the intervention group were (70.12±9.96) and (75.00±7.89),which were higher than the scores [(64.52±9.9) and (70.21±9.3)] for the control group (t=2.577,2.588;P<0.05). While the ADL scores that one month after surgery had no statistical differences between two groups (t=-1.185,P>0.05). The time of recoving independent walking in the control group was longer than that in the intervention group [(3.71±1.59) d vs (5.20±2.03) d;t= -3.848;P<0.05]. The average hospitalization time in the intervention group was shorter than that in the control group [(9.29±4.03) d vs (11.07±3.28) d;(t=2.283;P<0.05)]. No complications (e.g. dislocation,infection,and symptomatic deep venous thrombosis) were observed after three months′ follow-up.Conclusions The ice compress combined with early walking training is beneficial for postoperative rehabilitation in THA patients without drainage. It can improve patients′ independent walking function and self-care ability and can accelerate the rehabilitation process.

Objective To assess the irregular shape of hematoma with math methods,which is one of the risk factors of hematoma enlargement.Methods We reviewed images data of patients with spontaneous intracerebral hemorrhage treated nonsurgically who underwent initial computed tomography (CT) within 6 hours and repeated CT within 48 hours of onset.The area(s),the circumference(L),the greatest diameter(A)and the transverse diameter(B)of the greatest hemorrhage CT slice was measured.The formula X=L/S waft used to calculate the value.We calculated the area(S1)and the circumference (L1) of the ellipse with A as its long diameter and B as its short diameter.The formula X1=S1/L1 was used to calculate the value. We used formula R=X/X1 to assess the irregular hematoma shape.The relationships between hematoma enlargement and R was analyzed. Results Thirty-one patients(25.8%) showed enlarged hematomas after admission.The larger the value of R,the more irregular the shape of hematoma.When R≥1.3,the shape of the hematoma was significantly irregular.36.0% patients with R≥1.3 had hematoma enlarged.compared with only 18.6% those with R<1.3(χ2=4.62,P=0.032).Conclusions The irregular shape index R Can be used to assess the shape of a hematoma. A particularly high likelihood of hematoma enlargement is observed in patients with an irregularly shape index R≥1.3.