Objective To compare short-term clinical outcomes and patient satisfaction between robotic-assisted total knee arthroplasty(TKA)and conventional TKA.Methods A retrospective analysis was conducted on data of 93 patients who underwent primary unilateral TKA for knee osteoarthritis from June 2022 to April 2023.Among them,46 patients underwent Mako robot-assisted TKA(robot group)and 47 patients underwent traditional manual TKA(traditional group).There was no statistical difference in general data between the two groups(P＞0.05).Follow-up data were collected to compare the differences in surgical indicators,postoperative pain,range of motion(ROM),Hospital for Special Surgery(HSS)score,and Forgotten Joint Score(FJS)between the two groups.Results The operation time of the robotic group was longer than that of the traditional group[(105.8±26.7)min vs.(77.0±14.9)min,P＜0.001].There were no significant differences in total blood loss,hip-knee-ankle(HKA)angle deviation value and deviation rate(HKA angle＞3°)between the two groups at 3 days after surgery(P＞0.05).The robotic group had lower Visual Analogue Scale(VAS)scores for pain than the traditional group at 3 days,2 weeks,and 6 months after surgery(P＜0.001,P＜0.001,P=0.021),and had better knee joint ROM at 3 days,2 weeks,and 3 months after surgery(P＜0.001,P=0.011,P＜0.001).The HSS score(P=0.001)and FJS score(P＜0.001)of the robotic group were better than those of the traditional group at 6 months after surgery.Conclusion Compared with conventional TKA,robot assisted TKA has milder early pain,better mobility,and higher overall postoperative satisfaction.

Objective:To explore the mechanism of social support and self-efficacy in rehabilitation exercise in the relationship between psychological resilience and kinesiophobia in hip fracture patients.Methods:Totally 284 hip fracture patients treated at the Department of Trauma and Orthopedics, Binzhou Medical University Hospital from May 2022 to April 2023 were selected by convenience sampling. Data were collected using the general information questionnaire, the Connor-Davidson Resilience Scale (CD-RISC), the Social Support Rating Scale (SSRS), the Self-Efficacy Rehabilitation Outcome Scale (SER), and the Tampa Scale for Kinesiophobia (TSK). Process 4.1 was used for chain mediation effect analysis.Results:The scores for the 284 hip fracture patients were as follows: CD-RISC (58.72±7.77), SSRS (29.70±5.11), SER (91.23±8.41), and TSK (38.07±3.65). Psychological resilience, social support, self-efficacy in rehabilitation exercise, and kinesiophobia were all significantly correlated pairwise (all P<0.01). Social support and self-efficacy in rehabilitation exercise had a chain mediation effect between psychological resilience and kinesiophobia, with mediation effect values of -0.020 and -0.079, accounting for 17.52% and 67.70% of the total effect, respectively. Conclusions:Psychological resilience directly influences the level of kinesiophobia in hip fracture patients and has an indirect effect through the chain mediation of social support and self-efficacy in rehabilitation exercise.

Objective:To understand the genome analysis and molecular typing of foodborne Yersinia enterocolitica ( Y.e) strains in Liaocheng City of Shandong Province from 2020 to 2021. Methods:The Y.e strains were isolated from raw meat and meat products. Then we made the strain identification, drug sensitivity test, virulence gene test, pulsed-field gel electrophoresis (PFGE), and whole genome sequencing (WGS). The genome sequencing data were assembled with the microbial genome annotation package. We performed the multilocus sequence typing (MLST) and core genome multilocus sequence typing (cgMLST) and used WGS-based single nucleotide polymorphism typing (wg-SNPs) method to carry out genetic evolution analysis with 14 domestic and Y.e genomes obtained from the NCBI. Results:A total of 21 strains of Y.e were detected from 165 samples, with a detection rate of 12.73%. The 20 strains of Y.e were sequenced successfully. The 20 strains of Y.e carries a variety of drug resistance genes and virulence genes, showing multiple drug resistance. The virulence gene PCR test showed that 21 strains of Y.e having two virulence genes. Cluster analysis of PFGE, MLST, and cgMLST showed that the genomics of 21 strains was highly diverse. The genetic evolution analysis of wg-SNPs showed that 20 Y.e strains could be divided into two main evolutionary branches. Conclusions:Y.e strains isolated from raw meat in Liaocheng City carry a variety of drug resistance genes and virulence genes, and the molecular typing is highly diverse, which may cause infection risk. The molecular biological monitoring of Y.e in raw meat should be strengthened, and genome sequencing and molecular typing detection be carried out to provide the theoretical basis for foodborne illness caused by Y.e.

During the chemotherapy phase, patients with acute leukemia exhibit a myriad of symptoms. These symptoms are interconnected and mutually influential, forming symptom clusters that severely impact the patient's quality of life. This article summarizes the concept of symptom clusters, types of symptom clusters in acute leukemia patients undergoing chemotherapy, influencing factors, and non-pharmacological intervention measures. The aim is to provide a foundation for medical professionals in designing management plans for symptom clusters in acute leukemia patients undergoing chemotherapy.

Objective:To analyze the clinical characteristics and risk factors of impaired liver and renal function in hospitalized patients with gout.Methods:A total of 494 hospitalized patients with confirmed gout were selected and divided into four groups according to liver and renal function, control(Con), impaired liver function (ILF), impaired renal function (IRF), and both function impaired (ILRF) group. Multivariate logistic regression was used to analyze the risk factors related with impaired liver and renal function.Results:Compared to Con group, ILF group were younger with shorter gout duration, higher body mass index, waist circumference, homeostasis model assessment for insulin resistance (HOMA-IR), serum uric acid, low density lipoprotein-cholesterol (LDL-C), total cholesterol, triglycerides, C reactive protein, higher prevalence of dyslipidemia, obesity, fatty liver, and monosodium urate crystal (MSU) deposition (all P<0.05). IRF group were older and with higher serum uric acid, serum creatinine, C reactive protein, and hypertension, MSU deposition prevalence, with lower prevalence of fatty liver (all P<0.05). Compared to ILF group, IRF group were older, with longer gout duration, lower level of body mass index, waist circumference, HOMA-IR, LDL-C, total cholesterol, triglycerides, lower prevalence of obesity, fatty liver, and higher prevalence of hypertension and type 2 diabetes (all P<0.05). The univariate logistic regression analysis showed that age( OR=0.941, 95% CI 0.906-0.977, P<0.001), serum uric acid ( OR=1.002, 95% CI 1.000-1.005, P=0.043), HOMA-IR ( OR=1.147, 95% CI 1.024-1.285, P=0.018), and MSU deposition ( OR=1.959, 95% CI 1.154-3.326, P=0.013) were the independent risk factors of impaired liver function, while the independent risk factors of impaired renal function were age ( OR=1.104, 95% CI 1.048-1.162, P<0.001), serum uric acid ( OR=1.007, 95% CI 1.004-1.010, P<0.001), and MSU deposition ( OR=2.393, 95% CI 1.191-4.805, P=0.014). Conclusions:Serum uric acid and MSU deposition are the common independent risk factors for impaired liver and renal function in patients with gout. Younger patients with insulin resistance are susceptible to impaired liver function, older patients with hypertension and diabetes are susceptible to impaired renal function.

Objective:To explore the main hindering factors of nutritional care for family caregivers of patients with digestive system neoplasms after surgery, so as to provide reference for nursing workers to improve the quality of nutritional care for family caregivers and formulate personalized intervention programs.Methods:From January to April 2021, the phenomenological research method was used to select 14 family caregivers of patients with digestive system neoplasms after surgery in the First Affiliated Hospital of Anhui Medical University for semi-structured interviews, and Colaizzi 7-step analysis method was used to analyze and collate the data.Results:The obstacles to nutritional care for family caregivers of patients with digestive system neoplasms after surgery extracted 4 themes and 9 sub-themes. The first theme was insufficient awareness of nutritional care, including caregivers' insufficient awareness of the importance of nutritional care and lack of awareness of nutritional risks related to assisted eating. The second theme was the lack of nutritional care ability, including lack of nutrition knowledge of caregivers, poor practical ability of caregivers and poor compliance and initiative of caregivers. The third theme was the difficulty in obtaining and using nutritional information, including limited access to information for caregivers and difficulties in using information for caregivers. The fourth theme was caregiver role barriers in nutritional care, including lack of social support and heavy family financial burden.Conclusions:Nursing workers can formulate individualized interventions for family caregivers' nutritional care barriers, promote the improvement of nutritional care quality of them and then improve patients' nutritional status and quality of life.

Objective:To explore the main hindering factors of nutritional care for family caregivers of patients with digestive system neoplasms after surgery, so as to provide reference for nursing workers to improve the quality of nutritional care for family caregivers and formulate personalized intervention programs.Methods:From January to April 2021, the phenomenological research method was used to select 14 family caregivers of patients with digestive system neoplasms after surgery in the First Affiliated Hospital of Anhui Medical University for semi-structured interviews, and Colaizzi 7-step analysis method was used to analyze and collate the data.Results:The obstacles to nutritional care for family caregivers of patients with digestive system neoplasms after surgery extracted 4 themes and 9 sub-themes. The first theme was insufficient awareness of nutritional care, including caregivers' insufficient awareness of the importance of nutritional care and lack of awareness of nutritional risks related to assisted eating. The second theme was the lack of nutritional care ability, including lack of nutrition knowledge of caregivers, poor practical ability of caregivers and poor compliance and initiative of caregivers. The third theme was the difficulty in obtaining and using nutritional information, including limited access to information for caregivers and difficulties in using information for caregivers. The fourth theme was caregiver role barriers in nutritional care, including lack of social support and heavy family financial burden.Conclusions:Nursing workers can formulate individualized interventions for family caregivers' nutritional care barriers, promote the improvement of nutritional care quality of them and then improve patients' nutritional status and quality of life.

Objective: To study the effect of postoperative application of tranexamic acid on recovery and prognosis of unilateral total hip arthroplasty. Methods: One hundred and twenty patients who received unilateral total hip arthroplasty in 541st General Hospital of Dongzhen Town from August 2016 to August 2018 were divided into observation group and control group by random number table method, with 60 cases in each group. The control group received intravenous injection of tranexamic acid 10 min before skin incision after anesthesia; on the basis of the control group, the observation group was given tranexamic acid intravenously again 3 h after operation, and the control group was no longer given repeated injection of tranexamic acid. The hemorrhage, hemoglobin (Hb), hematocrit(HCT), hip joint Harris score and complications were compared between the two groups. Results: There was no significant difference in intraoperative blood loss and transfusion between the two groups (P>0.05); the drainage volume, total blood loss, dominant blood loss and recessive blood loss in the observation group were lower than those in the control group [(227.43 ± 20.14) ml vs. (280.91 ± 23.56) ml, (601.01 ± 42.84) ml vs. (667.04 ± 49.21) ml, (281.93 ± 18.50) ml vs. (322.06 ± 21.23) ml, (330.94 ± 21.73) ml vs. (370.03 ± 25.90) ml] (P<0.05). After operation 3 d, the levels of Hb and HCT in observation group were higher than those in control group [(117.07 ± 9.60) g/L vs. (102.19 ± 8.31) g/L, (35.05 ± 2.91)% vs. (32.01 ± 2.77)%] (P<0.05). After operation 2 weeks and 1 month after operation, the hip joint Harris score in observation group was higher than that in control group [(52.03 ± 4.02) scores vs. (48.37 ± 5.05) scores, (67.86 ± 5.29) scores vs. (61.23±5.10) scores] (P<0.05). There was no significant difference in the occurrence of intermuscular venous thrombosis, local hematoma and incision exudation between the two groups(P>0.05). Conclusions On the basis of preoperative application of tranexamic acid, combined postoperative application of tranexamic acid can significantly reduce the blood loss after unilateral total hip arthroplasty, and help the early recovery of joint function, without increasing complications and with high safety.

Objective To explore the effect of self-care agency on the self-perceived burden of patients with permanent bladder fistula. Methods From January 2016 to January 2017,the general data questionnaire,the Self-Perceived Burden Scale(SPBS),the Exercise of Self-Care Agency Scale(ESCA)was used to investigate 388 cases of permanent bladder fistula in 2 hospitals in Lanzhou, Baiyin and Dingxi city, and the results were statistically analyzed. Results The total score of SPBS was (36.01 ± 1.34) points,which was in the middle level.The total score of ESCA was(51.05±10.23)points,which was in low level.The total score of SPBS was negatively correlated with the total score of ESCA and each dimension (r =-0.496--0.168, P<0.01 or 0.05). Stratified regression analysis showed that self-care skills, self-responsibility, self-concept and health knowledge level in self-care ability were important influencing factors (P<0.05). Conclusions Nursing staff can improve the self-care ability, reduce the self-perceived burden,and improve the quality of life of patients.

Objective To evaluate different detection methods in the diagnosis of severe fever with thrombocytopenia syndrome (SFTS), and find the most quick and accurate one for the identification of new bunyavirus infection. Methods Real-time PCR and ELISA-IgM were used to detect serum samples of 158 patients with acute phase of SFTS, which were collected from the special monitoring system of SFTS in Henan Province in 2014. IgM and IgG antibodies were detected by ELISA in 109 acute and convalescent paired serum specimens. The differences of the positive rates were compared between the three methods, and the influence of the collected interval time on the detection results was analyzed. Results For 158 acute phase serum samples of SFTS patients, the positive rate detected by real-time PCR (76.58%) was higher than that of ELISA-IgM (47.47%), and the difference was statistically significant (χ2=34.13, P < 0.05). For 109 cases with acute and convalescent paired serum samples, there was no significant difference in the positive rates between ELISA-IgG ( 75.23%) and real-time PCR (72.48%) detections (χ2=0.18, P>0.05). In both the acute phase and convalescent phase, the positive rate of IgM was higher than that of IgG, and the difference was statistically significant (χ2=41.68 and 6.25, P<0.05). With the extension of collected interral time, the positive rates of IgM and IgG antibodies were both increased ( Z=6.42 and 10.08, P < 0.05). Conclusion Real-time PCR is the most sensitive method for the early diagnosis of the SFTS. ELISA-IgG is suitable for the detection of SFTS at recovery period. ELISA-IgM can be used as an assistant method to guide clinical diagnosis.