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.

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 construct a virtual simulation training platform for peripheral inserted central catheter (PICC) catheterization and discuss its application in clinical training.Methods:A total of 118 nurses who attended the PICC professional and technical advanced training courses in a province in 2020 and 2021 were enrolled in this study. In 2020, the training was conducted in the form of theoretical teaching combined with practical training ( n=51), and in 2021, virtual simulation platform was introduced as a supplement on the basis of the original training ( n=67). SPSS 23.0 was used for independent-samples t-test to compare the theoretical and operational assessment results of the two years and evaluate the application effect of the platform. Through the satisfaction survey and learning log, the nurses' experience of using the platform was understood. Results:The theoretical performance and the operational performance of nurses who participated in the training in 2021 were (96.56±3.17) and (94.06±2.16) respectively, and the operational performance was better than that of nurses who participated in the training in 2020 ( t=-11.37, P<0.001), and the difference in theoretical performance was not statistically significant ( t=0.17, P=0.853). In 2021, 63 nurses (94.0%) who used the virtual simulation platform believed that the platform could assist to improve the training effect; 61 nurses (91.0%) expected the application of virtual simulation technology in the teaching and training of other knowledges. Conclusion:As a new teaching form, virtual simulation technology can significantly improve the training effect and satisfaction, and provide reference for the development of relevant teaching and training.

In December 2019, the corona virus disease 2019 (COVID-19) broke out in Wuhan, Hubei Province. Although the number of newly confirmed COVID-19 cases in provinces outside of Hubei Province has declined continuously since February 4, the epidemic of COVID-19 remains serious. As companies resume work, it is still inevitable that some high-energy orthopedic trauma patients and elderly patients with low-energy fractures will need surgical treatment. The operating room, as a place for close contact between doctors, patients and nurses, increases the risk of infection and transmission. Based on the current needs of orthopedic trauma patients and the situation of the country's resistance to the epidemic of COVID-19, the authors expound the operating room management, preparation of medical materials, transfer of patients needing surgery, intraoperative protection and post-operative end disinfection in Third Hospital of Hebei Medical University so as to provide reference for prevention and control management of the operating room during the epidemic period.

Although the epidemic outbreak of Corona Virus Disease 2019 (COVID-19) restricted freecoming and going of people, it was inevitable that fracture patients, elderly ones with low-energy fracture in part ICU lar, sought medical attention. In this special situation, itwas crucial for trauma orthopaedists to do well in prevention and control of COVID-19 infection and in perioperative management of their patients as well while they went on with routine diagnosis and treatment. It was also of great significance for prognosis of the patients and prevention and control of the epidemic that orthopaedic surgeons chose proper surgical and anesthesia methods. In the process of diagnosis, treatment, nursing and rehabilitation, medical staff too was challenged by how to prevent themselves from infection and how to eliminate cluster COVID-19 transmission. This paper, from the perspectives of orthopedic surgeons, nurses and patients, expounds briefly on the management of patients with orthopedic trauma during the epidemic period of COVID-19 in a mode of multidisciplinary comprehensive interventions.

A new-type digital electric plum-blossom needle instrument of controllable and adjustable parameters was developed to achieve an automatic tapping instead of manual tapping technique and integrate the function of plum-blossom needle with that of micropulse electrical phase. The alternating current of periodic variation changes the direction of magnetic field around, induces the vibration of the cone head and tapping movement, outputs the micropulse current and acts on the affected area in treatment. The new-type digital electric plum-blossom needle instrument achieves the automatic tapping movement, precisely adjusts the stimulating strength and frequency according to diseases and integrates the tapping stimulation with pulse current to form circulation loop on the skin and intensify the therapeutic effects. This instrument is the big innovation of traditional plum-blossom needle. It is not only applicable for clinical treatment or family healthcare, but also for scientific research with the adoptable digital therapeutic parameters, which benefits the application and development of plum-blossom needle therapy.

Investigating the influence of acupuncture on cellular signal transduction is an efficient pathway to reveal the action mechanism of acupuncture on spinal cord injury (SCI). In this study, the experiment research literature regarding acupuncture for SCI during past 10 years was reviewed and analyzed. As a result, it was found that acupuncture could regulate the expression of the first intercellular messenger as well as the second signal molecules including cyclic adenosine monophosphate, cyclic guanosine monophosphate, Ca2+, nitric oxide to intervene the apoptotic signaling pathway, Rho/Rock signaling pathway, Wnt signaling pathway, MAPK signaling pathway, Notch signaling pathway, etc., which could improve regeneration and repair of SCI. In conclusion, in future researches more attention should be paid to the cellular signal transduction networks and different effects among various acupoint combinations and acupuncture modalities on cellular signal transduction, which have an essential role for revelation of clinical application rules and optimization of clinical treatment protocol.

Objective To observe the effect of electroacupuncture on Caspase-9, cytochrome C (Cyt-C) and apoptotic protease activating factor 1 (Apaf-1) protein in rats with neurogenic bladder after complete spinal cord injury. Methods A total of 60 female Sprague-Dawley rats were involved, in which 36 rats were randomly selected to establish the neurogenic bladder model with T10 spinal cord transected. 24 successful models selected were randomly divided into model group (n=12) and electroacupuncture group (n=12). The other 24 rats were also randomly divided into sham group (n=12) and blank group (n=12). The electroacupuncture group was electroacupunctured on Ciliao (BL32), Zhongji (RN3), Sanyinjiao (SP6) and Dazhui (GV14) for seven days. All of them were assessed with urodynamic test, TUNEL method was used to determine the apoptosis rate of the spinal cord, and Western blotting was used to detect the expression of Caspase-9, Cyt-C and Apaf-1 protein. Results Compared with the blank group and the sham group, the maximum bladder capacity and compliance decreased (P<0.01), the urinary bladder pressure and leakage point pressure increased (P<0.05); the apoptosis rate of the spinal cord increased (P<0.001); the expression of Caspase-9, Cyt-C and Apaf-1 protein increased (P<0.05) in the model group and the electroacupuncture group. Compared with the model group, the maximum bladder capacity and compliance increased (P<0.01), the urinary bladder pressure and leakage point pressure decreased (P<0.05); the apoptosis rate of the spinal cord decreased (P<0.05); the expression of Caspase-9, Cyt-C and Apaf-1 protein decreased (P<0.05) in the electroacupuncture group. Conclusion Electroacupuncture on Ciliao, Zhongji, Sanyinjiao and Dazhui could improve the bladder function after spinal cord injury in rats. The mechanisms may be related with the down-regulation of Caspase-9, Cyt-C and Apaf-1 protein to reduce apoptosis.

OBJECTIVETo observe the influence of electroacupuncture (EA) at lower-sea points of stomach, large intestine, small intestine and gallbladder on interleukin-1β (IL-1β), high mobility group protein 1 (HMGB 1) and alpha 7 nicotinic acetylcholine receptor (nAchR α7) in rats with acute gastric mucosal lesion (AGML), so as to explore whether there is relative specificity in treating gastric viscera disease by stimulating Zusanli (ST 36).

METHODSSixty healthy SD rats were randomly assigned into a blank group, a model group, a Zusanli group, a Shangjuxu group, a Xiajuxu group and a Yanglingquan group, ten rats in each one (half male and half female). The WRS method was applied to induce the AGML model except the rats in the blank group. The rats in the blank group were treated with routine diet; the rats in the model group were treated with immobilization at rat platform, 30 min per time; the rats in the Zusanli group, Shangjuxu group, Xiajuxu group and Yanglingquan group were treated with acupuncture and connected with EA device (dilatational wave 10 Hz/50 Hz, positive electrode on the left side and negative electrode on the right side, intensity was appropriate when rat hind leg slightly shook), 30 min per time. The treatment was given once a day. After consecutive 10-day treatment, the gastric tissue was collected and the damage of gastric mucosa was evaluated; ELISA method was applied to measure the content of serum IL-1β and tissue HMGB 1; the Western blot method was applied to measure the expression of nAchR α7 receptor.

RESULTS(1) Compared with the model group, the ulcer index (UI) of gastric mucosa, serum IL-1β and tissue HMGB 1 were lower, and the expression of nAchR α7 was increased in the remaining groups (<0.05,<0.01). (2) Compared with the Zusanli group, the UI of gastric tissue, serum IL-1β and tissue HMGB 1 were higher in the Shangjuxu group, Xiajuxu group and Yanglingquan group (<0.05,<0.01), and the expression of nAchRα7 was reduced in the Yanglingquan group (<0.01).

CONCLUSIONS(1) EA at digestive system-related lower-sea points, through IL-1β, HMGB 1 and nAchR α7, could regulate immune response, lighten inflammatory reaction and reduce mucosal injury, which could realize the intervention effect on AGML rats. (2) From the comparison, it is concluded the intervention effect of Zusanli group is superior to the other groups, partly indicating the relative specificity between Zusanli and stomach.

Objective To establish the rat model for neurogenic bladder after complete suprasacral spinal cord injury, and analyze the urodynamics. Methods Forty adult Sprague-Dawley rats were randomly divided into control group (n=10) and experimental group (n=30). The spinal cord injury model on T10 was made with modified spinal cord transaction. The Crede's method was used to urinate assistantly af-ter modeling. The amounts of urine and successful rat model everyday were recorded. The urodynamics was measured in both groups, and the morphology was observed with HE staining. Results Four rats died in the experimental group. The amount of urine was the least and sta-ble on the 18th day, and 24 rats were successfully modeled on the 21st day. Compared with the control group, maximum bladder capacity de-creased (t=3.150, P=0.021), bladder base pressure, maximum bladder pressure and leak point pressure increased (t>3.125, P<0.01), and blad-der compliancy decreased (t=5.330, P=0.002) in the experimental group. Conclusion The complete suprasacral after spinal cord injury of neurogenic bladder in a rat model of manufacturing method is of high reliability, good repeatability, and low coefficient of variable character-istics for spastistic neurogenic bladder basic experimental studies.