Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective:To compare the application effects of the solution-focused nursing model (SFNM) and conventional care in the perioperative care for patients with pelvic fractures.Methods:A retrospective cohort study was conducted to analyze the clinical data of 62 patients with pelvic fractures admitted to the Third Affiliated Hospital of Southern Medical University between February 2023 and July 2023, including 41 males and 21 females, aged 26-63 years [(44.1±15.7)years]. All the patients underwent open or closed reduction and internal fixation. According to different perioperative nursing intervention, 31 patients were treated with conventional care (conventional care group) and 31 with SFNM intervention based on conventional care (SFNM group). A comparative analysis was conducted between the two groups regarding general self-efficacy scale (GSES) score, Barthel index (BI) score, self-rating anxiety scale (SAS) score, and self-rating depression scale (SDS) score preoperatively, at discharge, and at 6 months postoperatively. The excellent-to-good rate of Majeed pelvic function score and nursing satisfaction at the final follow-up and perioperative complication incidence were compared between the two group.Results:All the patients were followed up for 12-15 months [(13.5±0.9)months]. No significant differences were observed between the two groups in GSES, BI, SAS or SDS scores ( P>0.05). At discharge, the GSES and BI scores in the SFNM group were (29.0±3.8)points and (37.4±8.7)points, significantly higher than (20.9±3.0)points and (31.5±12.1)points in the conventional care group ( P<0.05); the SAS and SDS scores were (41.9±5.1)points and (40.6±4.9)points in the SFNM group, significantly lower than (53.7±9.1)points and (42.9±7.5)points in the conventional care group ( P<0.01). At 6 months postoperatively, the SFNM group achieved GSES and BI scores of (34.0±4.0)points and (40.3±9.0)points, significantly higher than (25.2±3.7)points and (35.7±10.5)points in the conventional care group ( P<0.05); the SAS and SDS scores were (45.8±5.0)points and (38.2±3.0)points in the SFNM group, significantly lower than (50.0±8.5)points and (40.7±6.5)points in the conventional care group ( P<0.01). At the final follow-up, the excellent-to-good rate of Majeed pelvic function score was 90% (28/31) in the SFNM group and 87% (27/31) in the conventional care group ( P>0.05). At the final follow-up, nursing satisfaction rate was 100% (31/31) in the SFNM group, significantly higher than 77% (24/31) in the conventional care group ( P<0.05). The perioperative complication rate was 6% (2/31) in the SFNM group, significantly lower than 38% (12/31) in the conventional care group ( P<0.05). Conclusion:Compared with conventional care, perioperative intervention with SFNM for patients with pelvic fractures can enhance self-efficacy and daily living self-care ability, reduce negative emotions such as anxiety and depression, improve nursing satisfaction, and lower the incidence of complications, making it worthy of clinical promotion.

Objective To construct and validate the application effect of a standardized nursing protocol for transoral endoscopic thyroidectomy via vestibular approach(TOETVA)led by nurses in operating room under guidance of enhanced recovery after surgery(ERAS).Methods Based on Del-phi method,a TOETVA protocol led by operating room nurses under ERAS guidance was constructed.Eighty patients were randomly divided into control group and experimental group using random number table method,with 40 cases in each group.The control group received routine nursing interventions,while the experimental group received the standardized TOETVA nursing protocol led by operating room nurses under ERAS guidance.The number of days of drainage tube indwelling,length of hospital stay,incidence of complications,anxiety levels,and nursing satisfaction were compared between the two groups.Results Compared with the control group,the experimental group had a shorter number of days of drainage tube indwelling and length of hospital stay,as well as higher nursing satisfaction(P＜0.05).There was no statistically significant difference in anxiety levels between the two groups before intervention(P＞0.05).After intervention,the score of the Self-Rating Anxiety Scale(SAS)in the experimental group decreased and was lower than that in the control group(P＜0.05).However,there was no statistically significant difference in the incidence of complications between the two groups(P＞0.05).Conclusion The construction of a standardized TOETVA nursing protocol led by nurses in operating room under ERAS guidance is scientific and effective.It has positive significance in shortening the drainage tube indwelling time and hospital stay,improving patients' anxiety,and en-hancing patients' nursing satisfaction.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective:To compare the application effects of the solution-focused nursing model (SFNM) and conventional care in the perioperative care for patients with pelvic fractures.Methods:A retrospective cohort study was conducted to analyze the clinical data of 62 patients with pelvic fractures admitted to the Third Affiliated Hospital of Southern Medical University between February 2023 and July 2023, including 41 males and 21 females, aged 26-63 years [(44.1±15.7)years]. All the patients underwent open or closed reduction and internal fixation. According to different perioperative nursing intervention, 31 patients were treated with conventional care (conventional care group) and 31 with SFNM intervention based on conventional care (SFNM group). A comparative analysis was conducted between the two groups regarding general self-efficacy scale (GSES) score, Barthel index (BI) score, self-rating anxiety scale (SAS) score, and self-rating depression scale (SDS) score preoperatively, at discharge, and at 6 months postoperatively. The excellent-to-good rate of Majeed pelvic function score and nursing satisfaction at the final follow-up and perioperative complication incidence were compared between the two group.Results:All the patients were followed up for 12-15 months [(13.5±0.9)months]. No significant differences were observed between the two groups in GSES, BI, SAS or SDS scores ( P>0.05). At discharge, the GSES and BI scores in the SFNM group were (29.0±3.8)points and (37.4±8.7)points, significantly higher than (20.9±3.0)points and (31.5±12.1)points in the conventional care group ( P<0.05); the SAS and SDS scores were (41.9±5.1)points and (40.6±4.9)points in the SFNM group, significantly lower than (53.7±9.1)points and (42.9±7.5)points in the conventional care group ( P<0.01). At 6 months postoperatively, the SFNM group achieved GSES and BI scores of (34.0±4.0)points and (40.3±9.0)points, significantly higher than (25.2±3.7)points and (35.7±10.5)points in the conventional care group ( P<0.05); the SAS and SDS scores were (45.8±5.0)points and (38.2±3.0)points in the SFNM group, significantly lower than (50.0±8.5)points and (40.7±6.5)points in the conventional care group ( P<0.01). At the final follow-up, the excellent-to-good rate of Majeed pelvic function score was 90% (28/31) in the SFNM group and 87% (27/31) in the conventional care group ( P>0.05). At the final follow-up, nursing satisfaction rate was 100% (31/31) in the SFNM group, significantly higher than 77% (24/31) in the conventional care group ( P<0.05). The perioperative complication rate was 6% (2/31) in the SFNM group, significantly lower than 38% (12/31) in the conventional care group ( P<0.05). Conclusion:Compared with conventional care, perioperative intervention with SFNM for patients with pelvic fractures can enhance self-efficacy and daily living self-care ability, reduce negative emotions such as anxiety and depression, improve nursing satisfaction, and lower the incidence of complications, making it worthy of clinical promotion.

Objective: To isolate the cariogenic Streptococcus mutans (Sm) strains and study the therapeutical effect of egg yolk antibody (IgY) of the Sm on dental caries development. Methods: Sm strains were isolated from the children's dental plaque samples. Morphological, biochemical and molecular biological methods were applied to identify the serotype, acid producing and adhesion abilities of isolated Sm strains. After inactivation one of the Sm strains was used as antigen to immune laying hens to collect and extract the specific anti-Sm IgY. The rats were infected with Sm (serotype e). After 16 weeks of infection, all the rats were found developing dental caries. The rats were then randomly divided into two groups. The rats in experimental group were supplied with diet containing anti-Sm IgY while the rats in control group with normal IgY. All rats were sacrificed after another 8 weeks' observation. The degree of caries for each rat was assessed using Keyes' method. Results: We isolated 7 Sm strains from the children's dental plaque samples in the present study. The numbers of serotype c, e, f, k were 3, 2, 0 and 2, respectively. All strains showed similar morphological and biochemical characters as standard UA159 Sm strain, and possessed strong capabilities of acid production and adherence. Interestingly, even the same serotypec strains, such as No.3 and No.7 strains, demonstrated significant difference on acid producing and adherence capabilities. After 16 weeks infection with serotype e strain, the rats' mandibular teeth were apparently decayed, and treatment with specific anti-Sm IgY obviously attenuated the development of caries in the experiment group rats (16.4±2.0) compared with that in the control group rats (30.2±9.3) (P<0.05) determined by Keyes' method. Conclusions Seven cariogenic Sm strains of different serotypes were isolated, which possesses similar morphology and biochemical characters. Although belonging to the same serotype strains they always show significant difference in acid-producing and adherencec apabilities. Further experiment provides evidences that the serotype e strain could obviously induce caries independently, and employment of specific anti-Sm IgY as passive immunotherapy additive might effectively inhibit the further development of dental caries.