Objective:To explore the influencing factors of postoperative abdominal infection in critically ill patients with trauma.Methods:A retrospective case-control analysis was conducted on the clinical data of 82 patients who underwent critical surgery in Beijing Shijingshan Hospital from July 2020 to September 2023. There were 52 males and 30 females. Age ranged from 19 to 63 years old, with an average age of (44.50±14.55) years. According to whether the patient has developed infection after surgery, they were divided into an infected group ( n=20) and an uninfected group ( n=62). To compare the differences between the two groups intraoperative data (bleeding volume, cholangioenterostomy, crystal infusion volume, colloid infusion volume, laparoscopic use, operation time and surgical incision length) and postoperative data (ascites, anastomotic leakage, preventive stoma, pulmonary infection). Normally distributed measurement data were expressed as mean±standard deviation ( ± s), and independent samples t-test was used for comparison between groups; Chi-square test was used for comparison between groups for count data. Single factor analysis and multivariate Logistic regression were used to analyze the risk factors for postoperative abdominal infection in critically ill patients with trauma. Results:The number of cases of biliary intestinal anastomosis, bleeding volume, crystal infusion volume, and colloid infusion volume in the infected group were 12 cases, (573.26±206.21) mL, (4 531.0±258.0) mL, and (1 612.0±96.0) mL, respectively. The uninfected group was 14 cases, (468.25±174.21) mL, (2 753.0±226.0) mL, and (1 105.0±85.0) mL, respectively. The difference between the two groups was statistically significant ( P<0.05). The incidence rates of postoperative ascites, anastomotic fistula, prophylactic stoma, and postoperative pulmonary infection in the infected group were 25.00%, 65.00%, 25.00%, and 55.00%, respectively, while those in the non infected group were 9.68%, 27.42%, 51.61%, and 24.19%, respectively. The difference between the two groups was statistically significant ( P<0.05). Multivariate logistic regression analysis showed that postoperative ascites, biliary intestinal anastomosis, postoperative anastomotic fistula, and postoperative pulmonary infection ( OR=5.504, 4.432, 18.172, 7.687, 95% CI: 1.456-20.754, 1.175-16.669, 4.752-69.418, 2.141-27.595, P<0.05) were risk factors for the risk of postoperative abdominal infection. Conclusion:The risk factors for postoperative abdominal infection in critically ill patients with trauma include postoperative ascites, biliary intestinal anastomosis, postoperative anastomotic fistula, and postoperative pulmonary infection. Special attention needs to be paid to postoperative monitoring and treatment.

Objective:To evaluate the effect of social media based behavioral intervention on promoting joint testing of HIV and syphilis in young men who have sex with men (MSM).Methods:After the recruitment, the participants who met the inclusion criteria were randomly divided (1∶1) into two groups, i.e. social media intervention group and control group. The control group was given routine voluntary counseling and testing (VCT) services. The intervention group was also given VCT services, besides; the comprehensive strategies through social media, including regular health education message and testing information sending, were given to them to strengthen the behavioral intervention. Follow up was conducted for the participants for 12 months after the intervention. The number and the proportion of young MSM receiving HIV and syphilis testing, and the reported proportion of the young MSM with sexually transmitted diseases (STD) symptoms between the intervention group and the control group were compared to evaluate the effect of the intervention.Results:A total of 315 young MSM were recruited (158 in the intervention group and 157 in the control group), in whom 248 young MSM completed the follow up. The follow-up rate was 78.7%. There was no significant difference in baseline characteristics between the intervention group and the control group (all P>0.05). The proportion of young MSM receiving more than one joint testing in the intervention group was slightly higher than that in the control group (53.2% vs. 48.4%, rate difference (RD): 4.8%, 95% CI: -7.5%-17.0%, P=0.448) without significant difference. However, in the young MSM who used condoms in the last anal sex, the proportion of those receiving more than one joint testing in the intervention group was higher than that in the control group (63.8% vs. 46.1%, RD: 17.7%, 95% CI: 1.5%-32.6%, P=0.035). In addition, the reported proportion of young MSM with STD symptoms in the intervention group was significantly lower than that in the control group (6.3% vs. 18.0%,RD: -11.7%, 95% CI: -20.6%- -3.0%, P=0.005). Conclusion:Compared with routine VCT, social media based behavioral intervention might promote joint HIV and syphilis testing in the young MSM who used condom in the study. It could significantly reduce the reporting proportion of STD symptoms, suggesting that this method can promote the AIDS and STD prevention related behaviors in young MSM.

Objective:To construct a training program for specialist nurse in Hybrid Operation Room based on the Context, Input, Process and Product (CIPP) model, and to explore its effect.Methods:Based on the CIPP model, a training program for specialist nurse in Hybrid Operation Room was constructed. From March 2020 to March 2021, 100 Operating Room nurses from Shanghai East Hospital affiliated to Tongji University were selected by convenience sampling and divided into the control group and the observation group, with 50 cased in each group. The control group adopted the conventional training for specialist nurses, while the observation group adopted the CIPP model training program for specialist nurses in Hybrid Operation Room. The training effect of the nurses in the Operating Room was compared between the two groups.Results:After the training, the scores of nurses in the observation group were higher than those in the control group in terms of specialist theory and operational skills, and the differences were statistically significant ( P<0.05) . After the training, the preoperative operation standard, intraoperative operation standard rate , operation standardization rate of surgical instruments and operation coordination of nurses in the observation group were better than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The training program for specialist nurses in hybrid surgery based on the CIPP model can improve the operational skills of nurses in the Hybrid Operation Room, and is conducive to improving the quality of Operating Room management.

Objective:To explore the effect of the operation process query system and the psychological impact on the surgical patient's family members.Methods:From April to October 2019, 198 family members of patients whose operation time> 1 hour were selected from the Shanghai East Hospital, Tongji University. The patients were divided into a control group and an observation group according to the order of operation, with 99 cases in each group. Both groups implemented preoperative visits, preoperative assessments, and preoperative education. The control group performed routine nursing of Operating Room and did not specifically inform family members of the information about the operation process during the operation. The family members of the observation group could view information about the operation process in the operation progress query system. The State-Trait Anxiety Inventory (S-AI) was used to assess the anxiety of the family members of the two groups of patients, and we compared the changes of pulse, respiration and blood pressure before and during the operation of the two groups of family members, and compared the satisfaction of the family members of the two groups after the operation.Results:The anxiety scores and vital signs of the family members of the two groups of patients during the operation were higher than those before the operation. The family members of the observation group had an intraoperative anxiety score of (49.01±7.91) , pulse (92.97±8.76) times/min, respiration (20.13±1.64) times/min, systolic blood pressure (122.06±11.69) mmHg, diastolic blood pressure (82.86±6.45) mmHg, all lower than those of the control group, the differences were statistically significant ( t=20.494, 6.749, 26.784, 4.387, 8.139; P<0.01) . The total satisfaction of the family members of the observation group after the operation was 95.96% (95/99) , and that of the control group was 63.64% (63/99) , and the difference was statistically significant (χ 2=34.932, P<0.01) . Conclusions:The application of the operation query system can effectively alleviate the psychological anxiety of the family members of the surgical patients and improve the satisfaction of the family members of the patients with the operation.

Objective To analyze the efficacy and safety of tetrandrine in the adjuvant treatment of relapsed/refractory acute leukemia (except M3).Methods A total of 58 patients with relapsed/refractory acute leukemia (except M3) admitted to six tertiary hospitals in Jiangsu Province from January 2015 to December 2017 were included in this study.The tetrandrine-adjuvant standard chemotherapy regimen and standard chemotherapy regimen were given to treatment and control groups respectively.There were 17 and 41 patients in treatment and control groups.The treatment group was given tetrandrine for 5 days before the use of standard chemotherapy.The dose of tetrandrine was 4 mg ·kg-1 ·d-1,and patients had continuous oral administration of 5 days.After that,the patients in the treatment group started chemotherapy immediately.On the other side,the control group received standard chemotherapy without any other multidrug reversal medicine.Then the clinical efficacy and safety outcomes in both groups were analyzed.Results In the treatment group,5,3,and 9 cases achieved complete remission (CR),partial remission (PR),and nonremission (NR) respectively,and the total effective (CR+PR) rate was 47.06 ％ (8/17);in the control group,14,10,and 17 cases achieved CR,PR,and NR,and the total effective rate was 58.54 ％ (24/41).There was no significant difference in the total effective rate between the two groups (x2 =0.64,P =0.424).There was no significant difference in the efficacy between the two groups of patients with different genders (P ＞ 0.05).When the disease duration was 6-11 months,the difference of efficacy between the two groups was statistically significant (P =0.041).There was no significant difference in the proportion of myeloid leukemia cells,white blood cell count,platelet count,red blood cell count,and hemoglobin between the two groups before and after treatment (all P ＞ 0.05).There was no significant difference in clinical safety indicators (urine,faecal routine,liver and kidney function,and electrocardiogram) between the two groups (all P ＞ 0.05).Conclusions Tetrandrine is more effective in patients with relapsed/refractory acute leukemia (except M3) with shorter duration of disease.Compared with chemotherapy alone,the clinical efficacy of adding tetrandrine in chemotherapy cannot be considered superior to the former.

Objective To Observe and evaluate the effect of hyperbaric oxygen therapy for patients with tracheotomy using ventilator lengthening tube. Methods 75 patients with tracheotomy in our hospital from January 2017 to January 2018 were divided into the study group (n = 38 cases) and the control group (n = 37 cases) according to the random number method. The control group used conventional oxygen inhalation while the study group used the ventilator tube after prolonged special oxygen hyperbaric oxygen pipe three (built-in ventilation pipe check valve) and bellows connecting an oxygen supply device, compared two groups of patients with oxygen inhalation methods suction phlegm oxygen concentration times and cabin, every time when treating. Results The rate of oxygen inhalation in the study group was 97. 37％ (37/38) higher than that of the control group (81. 08％ (30/37)), and the difference was statistically significant (P＜0. 05). The number of sputum sucking in the study group was (1. 02 ± 0. 36) times less than that of the control group (2. 32 ± 0. 53), and the difference was statistically significant (P＜0. 05). The total time of hospitalization in the study group was (16. 4 ± 2. 4) d, and the total time of hospitalization in the control group was (21. 7 ± 3. 2) d, the difference was statistically significant(WTBX〗P＜0. 05). The score of GCS in the study group was higher than that of the control group, and the difference was statistically significant (P＜0. 01). Conclusion The ventilator extension tube for hyperbaric oxygen therapy in patients with tracheotomy improves the oxygen concentration, ensures the curative effect, reduces the oxygen concentration in the cabin and reduces security risks; the operation method is safe, simple and practical and convenient for clinical application.

To explore the clinical characteristics ,as well as diagnosis and treatment , of antineutrophil cytoplasmic autoantibody‐associated vasculitides (ANCA‐AAV )with pulmonary infection as the initial manifestation , by analyzing the clinical data of 8 elderly patients with ANCA‐AAV with pulmonary infection as the initial manifestation .Six patients ,who had received treatment of methylprednisolone 1 mg/(kg · d) for 4 to 6 weeks ,switched over to tapering prednisone .Three of the six cases received immunosuppressive cyclophosphamide 2 mg/(kg · d) orally for 1 year simultaneously ,of which one case received tripterygium wilfordii 1 mg/(kg · d) in addition for 3 months .The other two cases did not receive glucocorticoid therapy due to death caused by renal fallure .Among the 8 patients ,apart from 2 patients died in renal fallure and one case of death due to respiratory fallure ,5 patients got significant improvement on symptoms as cough ,sputum ,anemia ,fatigue , muscle aches ,and their body temperature returned to normal .Thus ,ANCA assay should be performed as early as possible for patients who had no specific clinical manifestation and showed no significant improvement to anti‐infection treatment . Administration of glucocorticoid may improve the prognosis of patients with ANCA‐AAV .