Abstract:Objective To explore the application effect of the nurse-led swallowing rehabilitation nursing team in patients with swallowing dysfunction after cerebral hemorrhage surgery.Methods A total of 96 patients with dysphagia after cerebral hemorrhage surgery admitted to Xinyi People's Hospital from January 2023 to October2024 were selected as the research subjects.They were divided into the observation group and the control group according to the random number table method,with 48 cases in each group.The control group received conventional intervention,while the observation group adopted the intervention of the nurse-led swallowing rehabilitation nursing team,and both groups were continuously intervened for 4 weeks.The clinical efficacy,the pre-and post-intervention scores of Standardized Swallowing Assessment(SSA)and Swallowing Quality of Life Questionnaire(SWAL-QOL),the pre-and post-intervention levels of hemoglobin(Hb),albumin(ALB),total protein(TP),as well as the incidence of complications and the satisfaction with nursing care were compared between the two groups.Results Compared with the control group,the total effective rate after 4 weeks of intervention in the observation group was higher(P<0.05).After 4 weeks of intervention,the SSA score of the observation group was lower than that of the control group,and the SWAL-QOL score was higher(P<0.05).After 4 weeks of intervention,the levels of Hb,ALB and TP in the observation group were all higher than those of the control group(P<0.05).Compared with the control group,the observation group had a lower incidence of complications and a higher total satisfaction rate with nursing(P<0.05).Conclusion Nurse-led swallowing rehabilitation nursing teams are conducive to promoting the early recovery of patients with dysphagia after cerebral hemorrhage surgery,improving their nutritional status and reducing the risk of complications.

Abstract:Objective To preliminarily explore the feasibility and safety of da Vinci robot-assisted transumbilical single-site laparoendoscopic surgery in the clinical application for gynecological diseases.Methods A retrospective analysis was conducted on the clinical data of 9 patients who underwent da Vinci robot-assisted transumbilical single-site laparoendoscopic surgery in the Department of Gynecology at the Third Affiliated Hospital of Nanjing Medical University(The Second People's Hospital of Changzhou)from March 2025 to July 2025.The clinical data were summarized and analyzed.Results The operation time for the 9 patients ranged from 115 to 335 minutes,with an average of(233.89±62.69)minutes.Their intraoperative blood loss ranged from 10 to 2 000 mL,with an average of(306.25±687.19)mL.The decrease in hemoglobin concentration ranged from 1 to 19 g/L,with an average of(9.11±7.13)g/L.The postoperative hospital stay ranged from 6 to 9 days,with an average of(7.89±1.17)days.Hospitalization costs ranged from 25 245.59 to 62 708.44 Chinese yuan,with an average of(42 930.31±11 700.41)Chinese yuan.Except for one patient with a giant uterine fibroid who experienced intraoperative massive bleeding and postoperative lower limb venous thrombosis,the surgeries for the other patients were completed smoothly.All 9 patients had a good recovery after surgery and were discharged smoothly,with good satisfaction regarding surgical time,postoperative recovery time,and incision cosmetic effects.Conclusion Under the premise of having a good foundation in single-site laparoendoscopic surgical techniques,the da Vinci robotic surgery system is safe and feasible for appropriate cases.

Abstract:Objective To explore the preventive effect of low-dose esketamine on catheter-related bladder discomfort(CRBD)after ureteroscopic holmium laser lithotripsy(URHL).Methods 100 patients who received URHL treatment in Changzhou Seventh People's Hospital from April 2023 to April 2025 were selected and divided into the observation group and the control group by the random number table method,with 50 cases in each group.The anesthesia induction and maintenance methods were the same in both groups.In the observation group,low-dose esketamine was pumped after anesthesia induction at a dose of 0.20 mg/kg,while esketamine was not used in the control group.The perioperative conditions,incidence and severity of CRBD,Visual Analogue Scale(VAS)score,levels of C-reactive protein(CRP)and interleukin-6(IL-6),and the incidence of adverse reactions were compared between the two groups.Results The time to getting out of bed and the hospital stay in the observation group were both shorter than those in the control group(P<0.05).The total incidence of CRBD in the observation group was lower than that in the control group(P<0.05),and the severity was relatively lower(P<0.05).The VAS scores at 2 hours and 6 hours after the operation in the observation group were lower than those in the control group(P<0.05).The levels of serum CRP and IL-6 at 12 hours after the operation in the observation group were both lower(P<0.05).The above differences were all statistically significant.In comparison of the total incidence of adverse reactions between the two groups(P>0.05),there was no statistical difference.Conclusion Low-dose esketamine helps prevent the occurrence of postoperative CRBD in patients with URHL,and can reduce the severity of CRBD,relieve postoperative pain and inflammatory response,with good safety.

Abstract:Objective To explore the effect of ultrasound-guided EnCor vacuum-assisted minimally invasive rotary resection of breast fibroma on the rehabilitation prognosis of patients.Methods A total of 150 breast fibroma patients from the Department of Breast Surgery,the First Affiliated Hospital of Guangdong Pharmaceutical University were selected from January 2024 to December 2024.All patients were randomly divided into two groups,75 cases in each group.All patients met the surgical indications.Traditional open incision surgery was carried out in the control group,and ultrasound-guided EnCor vacuum-assisted minimally invasive rotary resection was performed in the study group.The surgical effects of the two groups were compared.Results The operation time,incision healing time and hospitalization time of the study group were shorter than those of the control group,and the incision length and intraoperative blood loss were better than those of the control group(all P<0.05).One month after operation,the proportion of patients with normal sensation in the operation area in the study group(81.33%)was significantly higher than that in the control group(68.00%,P<0.05).The aesthetic scores of breast surface in the study group were significantly higher than those in the control group at 1 week and 1 month after surgery(both P<0.05).The incidence of complications in the study group(9.33%)was significantly lower than that in the control group(24.00%)(P<0.05).There was no significant difference in the recurrence rate between the two groups 1 year after operation(P>0.05).Conclusions The application of EnCor vacuum-assisted minimally invasive rotary resection with ultrasound in patients with breast fibroma has outstanding surgical effect,good prognosis and rehabilitation,and is worthy of recommendation.

Abstract:Objective To explore the influence of evidence-based nursing intervention on the surgical site infection(SSI)rate and rehabilitation effect of patients after acoustic neuroma surgery.Methods A total of 72 patients undergoing acoustic neuroma surgery in the Fourth People's Hospital of Shenzhen from December 2022 to December 2024 were selected and divided into the experimental group(n=36)and the control group(n=36)according to the random number table method.The control group received routine care,while the experimental group adopted evidence-based nursing intervention on the basis of routine care.The healing conditions of surgical sites,healing time,hospital stay,incidence of SSI,levels of inflammatory indicators(PCT,CRP),and satisfaction with nursing were compared between the two groups.Results The rate of Grade A healing(91.67%vs 66.67%)and the total satisfaction rate with nursing(97.22%vs 75.00%)in the experimental group were significantly higher than those in the control group(P<0.05),and the total incidence of SSI(5.56%vs 25.00%)was significantly lower than that in the control group(P<0.05).The healing time and hospital stay of the experimental group were both shorter than those of the control group(P<0.001),and the levels of PCT and CRP one day after the operation were also lower than those of the control group(P<0.001).Conclusion Evidence-based nursing intervention can effectively promote incision healing in patients after acoustic neuroma surgery,reduce the risk of SSI,alleviate inflammatory responses,shorten hospital stay,and improve patient satisfaction.It has significant clinical promotion value.

Abstract:Objective To explore the effect of multidimensional nursing based on physical signs,psychology and life behavior in patients undergoing cervical cerclage during pregnancy.Methods A total of 86 pregnant patients who underwent cervical cerclage at Nantong Maternity and Child Health Hospital from January 2023 to June 2025 were selected for this study.All patients were randomly assigned to an observation group and a control group,with 43 patients in each group.The control group received a standard nursing plan,while the observation group received additional three-dimensional nursing intervention based on physical signs,psychology and life behavior.Complications,pre-and post-intervention scores on the Positive Psychological Capital Questionnaire(PPQ),satisfaction with nursing,and quality of life were assessed in both groups.Results The incidence of complications in the observation group was 13.95%,significantly lower than the 44.19%observed in the control group(P<0.05).Following intervention,PPQ scores increased significantly in both groups,with the observation group demonstrating significantly higher scores than the control group(P<0.05).Patient satisfaction with nursing care reached 90.70%in the observation group,significantly exceeding the 72.09%reported in the control group(P<0.05).Post-intervention quality of life scores improved in both groups,with the observation group achieving significantly higher scores compared with the control group(P<0.05).Conclusion Three-dimensional nursing care based on physical signs,psychology and life behaviors can significantly reduce the incidence of complications in patients undergoing cervical cerclage during pregnancy,and improve their psychological capital level,satisfaction with nursing and quality of life,which has clinical application value.

Abstract:Objective To evaluate the efficacy of endoscopic balloon dilatation(EPBD)and the combination of balloon dilatation with small endoscopic sphincterotomy(sEST)in middle-aged patients with extrahepatic bile duct stones.Methods Through retrospective analysis,81 patients with extrahepatic bile duct stones aged from 40 to 59 years from January 2022 to December 2023 were divided into EPBD group(n=40)and sEST+EPBD group(n=41)according to different surgical methods.The operation time,the one-time stone removal rate,the number of mechanical lithotripsy sessions,the postoperative hospital stay,the hospital expenses,the postoperative pancreatitis,bleeding and intestinal perforation,and the stone recurrence rate one year after operation were compared between the two groups.Results Compared with EPBD group,sEST+EPBD group had higher one-time stone removal rate(P<0.049),but there were no statistical differences in operation time(P=0.120)and the number of mechanical lithotripsy sessions(P=0.699).There was no statistical difference in the postoperative hospitalization days between the two groups(P=0.817).The hospitalization expenses in EPBD group were lower than those in sEST+EPBD group(P<0.001).There were no significant differences between the two groups in postoperative complications such as pancreatitis,bleeding and intestinal perforation,and in stone recurrence rate one year after operation.Conclusion EPBD group and sEST+EPBD group have their own advantages in the treatment of middle-aged patients with extrahepatic bile duct stones.The hospitalization expenses in EPBD group are lower,and the one-time stone removal rate in sEST+EPBD group is higher.

Abstract:Objective To explore the effect of cisatracurium combined with etomidate on anesthesia efficacy and perioperative adverse events in patients with open reduction and internal fixation.Methods A total of 86 patients scheduled for open reduction and internal fixation at Peking University First Hospital Taiyuan Hospital from January 2024 to January 2025 were selected as the research subjects and randomly divided into a control group and a study group,with 43 cases in each group,using a random number table.All patients underwent open reduction and internal fixation.The control group was anesthetized with rocuronium combined with etomidate,while the study group was anesthetized with cisatracurium combined with etomidate.The anesthesia efficacy(anesthesia onset time,anesthesia maintenance time,anesthesia depth,degree of muscle relaxation),the surgical incision healing indicators(healing grade,healing days),the postoperative recovery situation(recovery time from anesthesia,extubation time,time of the first out-of-bed activity,time of exhaust,defecation time),and the perioperative adverse events(incision infection,redness and swelling,exudation,nausea and vomiting)were compared between the two groups.Results There were no statistically significant differences between the two groups in anesthetic depth,muscle relaxation degree,healing grade,bone healing days,time to first ambulation,exhaust/defecation time,or overall incidence of perioperative adverse reactions(P>0.05).The study group had longer anesthetic onset time[(3.25±0.56)min vs.(2.18±0.32)min],anesthetic maintenance time[(80.52±12.45)min vs.(65.48±10.23)min],awakening time[(30.56±5.23)min vs.(25.18±4.15)min]and extubation time[(45.68±8.12)min vs.(38.25±7.05)min]compared with the control group(P<0.05).The incidence of postoperative residual muscle relaxation was lower in the study group[5 cases(11.63%)vs.13 cases(30.23%)](P<0.05).These differences were statistically significant.Conclusion In open reduction and internal fixation,compared with rocuronium,the use of cisatracurium combined with etomidate can prolong anesthetic onset time,maintenance time,awakening time and extubation time,but significantly reduce the incidence of postoperative residual muscle relaxation without increasing other perioperative adverse reactions or affecting healing and intestinal function recovery.No significant effects on bone healing and bowel function are observed.

Abstract:Objective To analyze the gastroscopy manifestations and the histopathological characteristics of gastric mucosa biopsy in patients with different types of intestinal metaplasia of precancerous lesions of gastric cancer.Methods A retrospective analysis was conducted on the clinical data of 228 patients with intestinal metaplasia of precancerous lesions of gastric cancer,who were admitted to Binhai Hospital of Traditional Chinese Medicine of Jiangsu Province from January 2024 to June 2025.The 228 patients were divided into the incomplete intestinal metaplasia group(129 cases)and the complete intestinal metaplasia group(99 cases)based on the results of hematoxylin-eosin staining and modified Alcian blue-PAS staining.The gastroscopy scores and histopathological manifestations of the two groups of patients were compared.Results There were no statistical differences in the scores of mucosal thinning,fold flattening,mucosal edema,exposed blood vessels,mottled mucosa,raised erosion and flat erosion under gastroscopy between the two groups of patients(P>0.05).Under gastroscopy,the scores of rough and uneven mucosa as well as intestinal metaplasia nodules in the incomplete intestinal metaplasia group were higher than those in the complete intestinal metaplasia group,and the differences were statistically significant(P<0.05).There were no statistical differences in the rates of erosion,lymphoid follicular formation,lymphocyte proliferation,dysplasia and atrophy between the two groups of patients(P>0.05).The rates of active inflammation and chronic inflammation in the incomplete intestinal metaplasia group were higher than those in the complete intestinal metaplasia group,and the differences were statistically significant(P<0.05).Conclusion There are significant differences in gastroscopy manifestations and pathological features between fully differentiated and incompletely differentiated intestinal metaplasia.Analyzing the gastroscopy manifestations and pathological features of patients with precancerous lesions of gastric cancer is conducive to clarifying the classification of intestinal metaplasia and guiding clinical intervention.

Abstract:Objective To determine the optimal interval for dressing changes after outpatient debridement and suture,and thus provide evidence for improving wound healing.Methods A total of 112 patients who underwent outpatient debridement and suture intervention in the Outpatient Department of Beijing Shunyi District Second Hospital from March 2022 to March 2025 were enrolled as study subjects.They were randomly divided into two groups in a 1:1 ratio based on the parity of their outpatient department tail numbers,with 56 patients in each group.The control group received dressing changes once every 3 days,while the study group received dressing changes on the first day postoperatively,the second day postoperatively,and once every 3 days thereafter,with additional changes as necessary based on the actual situation.The wound-healing outcomes,visual analogue scale(VAS)scores from postoperative day 1 to day 10,complications,and satisfaction ratings were compared between the two groups.Results Compared with the control group,the study group showed a significantly higher overall wound-healing rate(P<0.05).VAS scores on postoperative days 2～10 were significantly lower in the study group(P<0.05),and healing time was significantly shorter(P<0.05).Both groups experienced varying degrees of hematoma,granulation tissue hyperplasia,and scab injury,with no significant difference in total complication rate(P>0.05).There were no significant differences in scores for gentleness of handling,technical proficiency or patient communication in the two groups(P>0.05).However,problem-solving score was significantly higher in the study group(P<0.05).Conclusion Implementing the principle of the first dressing change on the first day,the second dressing change on the next day,and then once every three days after debridement and suturing surgery may help promote wound healing and improve patient satisfaction.

Abstract:Objective To explore the application effect and prognosis influence of laparoscopic D 2+complete mesangastrium excision(CME)based on membrane anatomy theory in locally advanced gastric cancer(LAGC).Methods A retrospective analysis was conducted on the clinical data of 80 patients with LAGC admitted to Suining County People's Hospital from July 2020 to July 2023.According to different surgeries,they were divided into the observation group with 44 cases and the control group with 36 cases.The control group was treated with traditional laparoscopic D2 radical resection,while the observation group was treated with laparoscopic D2+CME surgery based on membrane anatomy theory.The perioperative conditions,and the changes of carcinoembryonic antigen(CEA),carbohydrate antigen(CA)199 and CA72-4 levels before and 3 days after the operation of the two groups were compared,and the incidence of postoperative complications and the recurrence during the 2-year follow-up were also compared.Results The intraoperative blood loss in the observation group was less,the number of dissected lymph nodes was higher,and the postoperative exhaust time and defecation time as well as hospital stay were shorter than those in the control group(P<0.05).The postoperative serum levels of CEA,CA199 and CA72-4 in the observation group were all lower(P<0.05).In comparison of the total incidence of complications between the two groups,there was no statistically significant difference(P>0.05).The 2-year postoperative follow-up showed that the number of recurrence cases in the observation group was lower than that in the control group,and the recurrence time and progression-free survival(PFS)were longer(P<0.05).Conclusion Laparoscopic D2+CME surgery based on membrane anatomy theory can increase the number of lymph node dissections in patients with LAGC,promote postoperative recovery,and improve the short-term prognosis of patients,with good safety.

Abstract:Objective To explore the risk factors for persistent hypocalcemia after radical resection of differentiated thyroid cancer(DTC)and to construct a risk prediction model for postoperative persistent hypocalcemia.Methods A retrospective analysis was conducted on the clinical data of 208 patients with DTC in the Department of Surgery of Xinghai Hospital and the Department of Thyroid and Breast Surgery of the First Affiliated Hospital of Soochow University from January 2021 to July 2025.According to whether persistent hypocalcemia occurred after the operation,the patients were divided into the hypocalcemia group(35 cases)and the normal blood calcium group(173 cases).A comprehensive risk prediction model for persistent hypocalcemia after DTC surgery was constructed by comparing the indicators with statistically significant differences between the the two groups through multiple regression analysis,and this model was verified.Results Gender,age,body mass index(BMI),hyperlipidemia,hypertension,diabetes mellitus,and lateral cervical lymph node dissection were not associated with the risk of persistent hypocalcemia after DTC surgery(P>0.05).The extent of resection,the scope of central lymph node dissection,tumor capsule invasion,operation time,accidental parathyroidectomy,and parathyroid hormone were associated with the risk of persistent hypocalcemia after DTC surgery(P<0.05).Total thyroidectomy,bilateral central lymph node dissection,dorsal capsule invasion,and accidental parathyroidectomy were identified as risk factors for persistent hypocalcemia after radical resection of DTC(P<0.05).A nomogram prediction model was established based on the above 4 risk factors.The predicted values were basically consistent with the measured values,indicating that the nomogram prediction model in this study had good predictive ability.The area under the receiver operating characteristic curve(AUC)was 0.871(95%confidence interval:0.837-0.903).Conclusion The nomogram model established in this study can predict the risk of persistent hypocalcemia after radical resection of differentiated thyroid cancer,providing a quantitative tool for clinical intervention.

Abstract:Objective To analyze the application effect of moist wound-healing nursing combined with continuous instillation and intermittent flushing negative pressure closure drainage(VSD)technology in burn plastic surgery patients.Methods 100 patients undergoing burn plastic surgery and admitted to Southeast University Affiliated Zhongda Hospital from January 2024 to January 2025 were selected.By using block randomization combined with a random number table,they were divided into two groups,with 50 cases in each group(double-blind design).The control group received routine nursing combined with routine VSD technique,while the observation group received moist wound-healing nursing combined with continuous instillation and intermittent flushing VSD technique.The wound healing time,Vancouver Scar Scale(VSS)scores,Visual Analog Scale(VAS)score,inflammatory factor levels(TNF-α,C-reactive protein(CRP),interleukin-6(IL-6),adverse reactions,and nursing satisfaction were compared between the two groups.Results Compared with the control group,the observation group had a shorter wound healing time(P<0.05).Before intervention,there were no significant differences in VSS scores,VAS score,and inflammatory factors levels between the groups(P>0.05).After intervention,compared with the control group,the observation group had lower scores in all dimensions of VSS(color,thickness,softness,vascular distribution)and in VAS(P<0.05).After intervention,compared with the control group,the observation group had lower levels of TNF-α,CRP and IL-6(P<0.05).The adverse reaction rate of the observation group was 6.00%,which was lower than the control group's 20.00%(P<0.05).The overall satisfaction rate of the observation group was 96.00%,which was higher than the control group's 82.00%(P<0.05).Conclusion The combination of moist wound-healing nursing with continuous instillation and intermittent flushing VSD technique has a good effect on burn plastic surgery patients,which can promote wound healing,alleviate scar formation,effectively ameliorate pain and inflammation,prevent adverse reactions,and increase patient satisfaction.

Abstract:Objective To explore the application effect of seamless nursing combined with enhanced surgical isolation technique under shared decision-making theory in heart valve replacement surgery.Methods 100 patients who underwent elective heart valve replacement surgery at the First People's Hospital of Lianyungang City from January 2024 to June 2025 were selected and randomly divided into two groups of 50 patients each using a random number sequence.The control group received routine care,while the observation group was implemented with seamless nursing combined with enhanced surgical isolation technique under the shared decision-making theory.The rehabilitation time,scores of postoperative cardiac symptoms using the Cardiac Symptom Survey(CSS),Cardiac Exercise Self-Efficacy Instrument(CESEI)score,and complications were compared between two groups.Results The observation group had faster postoperative bowel sound recovery,shorter time to first defecation and getting out of bed,and shorter hospitalization time compared with the control group(P<0.05).The scores of postoperative cardiac symptoms(fatigue,depression,sleep disorders,anxiety,poor appetite)on the CSS scale in the observation group were lower than those in the control group(P<0.05).After intervention,the CESEI scores of both groups increased compared with before intervention,and the self-efficacy of cardiac rehabilitation training in the observation group was higher than that in the control group(P<0.05).The incidence of postoperative complications in the observation group was 6.00%,lower than the 22%in the control group(P<0.05).Conclusion The application of seamless nursing combined with enhanced surgical isolation technique under shared decision-making theory in heart valve replacement surgery has significant effects,which can shorten the recovery time of patients,improve the self-efficacy of rehabilitation training,alleviate postoperative cardiac discomfort symptoms,and reduce the risk of complications.

Abstract:Objective To explore the effect of preoperative pretreatment with different doses of midazolam on laparoscopic appendectomy in children.Methods 96 children who underwent elective laparoscopic appendectomy from January 2023 to June 2024 were selected and divided into a low-dose group(group M1),a high-dose group(group M2),and a control group(group C)by the random number table method,with 32 cases in each group.Group M1 took midazolam at a dose of 0.3 mg/kg orally 30 minutes before the operation,group M2 took midazolam at a dose of 0.5 mg/kg orally,and group C took the same amount of 5%glucose solution orally.The anesthesia induction and maintenance methods during the operation were the same in the three groups.The perioperative conditions,the modified Yale Preoperative Anxiety Scale(m-YPAS)scores before administration and before entering the operating room,and the induction compliance checklist(ICC)scores before anesthesia induction were compared among the three groups.The scores of the Pediatric Anesthesia Awakening Restlessness Scale(PAED)immediately,6 hours and 24 hours after surgery,as well as the incidences of restlessness and adverse reactions were compared among the three groups.Results The dosage of sufentanil during the operation in group M2 was less than that in group M1 and group C,and the dosage in group M1 was less than that in group C(P<0.05).The m-YPAS score before entering the operating room and the ICC score in group M2 were lower than those in group M1 and group C,and the scores of group M1 were lower than those of group C(P<0.05).The PAED scores immediately after surgery in group M2 were lower than those in group M1 and group C,and the scores of group M1 were lower than those of group C(P<0.05).The difference in the incidence of restlessness among the three groups was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion Oral midazolam pretreatment 30 minutes before laparoscopic appendectomy in children can reduce the dosage of sufentanil during the operation,relieve preoperative anxiety,improve compliance with anesthesia induction,and lower the incidence of awakening restlessness,with the effect of a dose of 0.5 mg/kg better than that of 0.3 mg/kg,while without increasing the risk of adverse reactions.

Abstract:Objective To explore the effect of quality control measures based on zero defect management theory on the quality control of surgical data on the first page of inpatient medical records.Methods A cluster sampling method was used to select 1308 pieces of surgical information on the first page of inpatient medical records at Suzhou Municipal Hospital from January 2024 to December 2024 for study.The patients were divided into two groups based on management methods:the control group received routine management,and the observation group received quality control management based on zero defect management theory.The first page qualification rate,surgical code accuracy,main diagnosis and main surgical situation,other surgical omission items,and other surgical omission departments of surgical related inpatient medical records of the two groups were compared.Results The qualification rate of the first page of surgery related inpatient medical records as well as the accuracy rate of coding other operations and major operations in the observation group were higher than those in the control group(P<0.05).The accuracies of main diagnosis,main operation,main diagnosis code and main operation code in the observation group were higher than those in the control group(P<0.05).There was no missing filling in the observation group,and the number of missing filling in the main operation and other operations was lower than that in the control group(P<0.05).The numbers of other surgical missing filling departments and missing filling copies in the observation group were lower than those in the control group(P<0.05).Conclusion Quality control management measures based on zero defect management theory can improve the quality of surgical data on the first page of inpatient medical records,and is conducive to improving the integrity of surgical data on the first page of inpatient medical records.

Abstract:Objective To explore the application effect of electromyography triggered rehabilitation robotic hand training combined with low-frequency repetitive transcranial magnetic stimulation(rTMS)in patients after skull repair surgery for traumatic brain injury.Methods 82 patients who underwent skull repair surgery for traumatic brain injury at the Rehabilitation Department of Jiande First People's Hospital from January 2023 to December 2024 were selected as the study subjects and randomly divided into a reference group(n=41)and a study group(n=41)using a random number table method.The reference group received routine rehabilitation training,while the study group received electromyography triggered rehabilitation robot hand training+rTMS on the basis of the reference group.The motor function assessed with Fugl-Meyer Assessment-Upper Extremity(FMA-UE)and Fugl-Meyer Assessment-Lower Extremity(FMA-LE),the daily living ability evaluated with Activities of Daily Living Scale(ADL),the cognitive ability evaluated with Mini-Mental State Examination(MMSE),and the bioelectrical feedback before and after intervention were compared between two groups.Results At 2 and 6 months after discharge,the FMA-UE scores of the study group[(52.11±2.02)and(61.02±1.78)]were higher than those of the reference group(t=8.991,2.346,P<0.05),and the FMA-LE scores[(27.43±1.85)and(32.03±0.58)]were also higher than those of the reference group(t=6.522,2.184,P<0.05).At 2 and 6 months after discharge,the ADL scores of the study group[(65.24±3.72)and(84.43±4.97)]were higher than those of the reference group(t=5.434,2.176,P<0.05).At 2 and 6 months after discharge,the MMSE scores of the study group[(21.55±2.02)and(25.78±1.25)]were higher than those of the reference group(t=4.017,2.467,P<0.05).At 2 and 6 months after discharge,the P300 amplitudes of the study group[(6.01±0.39)μV and(6.89±0.41)μV]were higher than those of the reference group(t=2.548,2.286,P<0.05).The incidence of adverse reactions between the reference group and the study group was 0 vs.4.88%,with no statistically significant difference(P>0.05).Conclusion The combination of electromyography triggered rehabilitation robotic hand training and rTMS intervention can improve the recovery of upper and lower limb motor function,enhance cognitive ability,promote the recovery of daily living ability,while does not increase the incidence of adverse reactions in patients after cranial repair surgery for traumatic brain injury.

Abstract:Objective To explore the application of evidence-based comfortable care in the anesthesia recovery period after thoracoscopic lobectomy.Methods 132 patients who underwent thoracoscopic lobectomy in our hospital from March 2023 to February 2024 were selected as the research subjects.They were divided into two groups according to the random envelope method,with 66 cases in each group.The control group was given routine care,while the observation group was given evidence-based comfortable care on the basis of the control group.Both groups were cared for until discharge.The occurrence of awakening agitation(EA)was compared between the two groups after the operation.The self-efficacy(SUPPH)scores(including positive attitude,self-stress reduction,self-decision-making and total score)and the European Cancer Treatment Research Organization Quality of Life Scale(QLQ-C30)were compared between the two groups before nursing,3 days after nursing and at discharge.The QLQ-C30(including functional domain,symptom domain,overall health status domain,and individual measurement items)and general comfort questionnaire(GCQ)(including physiological,psychological,sociocultural and environmental dimensions)were compared between the two groups at discharge.Results The incidence of EA in the observation group was 9.09%,which was lower than that in the control group(22.73%,P<0.05).After 3 days of nursing and at discharge,the SUPPH scores in the observation group were higher than those in the control group(P<0.05).After nursing for 3 days and upon discharge,the functional and overall health status scores of the QLQ-C30 scale in the observation group were higher than those in the control group(P<0.05),while the symptom domain and individual measurement item scores were lower than those in the control group(P<0.05).After nursing for 3 days and at discharge,the comfort scores of the observation group were higher than those of the control group(P<0.05).The intervention satisfaction of the observation group was higher than that of the control group(P<0.05).Conclusion Evidence-based comfortable care for patients after thoracoscopic lobectomy can reduce the occurrence of agitation during anesthesia recovery period and improve patients'self-efficacy and comfort.

Abstract:Objective To investigate the relationship between vaginal microecological imbalance and high-risk human papillomavirus(HR-HPV)infection after cold knife conization(CKC)in patients with high-grade squamous intraepithelial lesion(HSIL)of the cervix.Methods One hundred patients with HSIL treated with CKC who were admitted to the Maternal and Child Health Care and Family Planning Service Center of Yingdong District,Fuyang City from January 2022 to March 2024 were selected as the research subjects.According to the follow-up of HR-HPV outcome 12 months after CKC,they were divided into HR-HPV negative group of 76 cases and HR-HPV positive group of 24 cases.Multivariate logistic regression analysis was used to analyze the risk factors of HR-HPV infection in patients with HSIL after CKC surgery.Results In the HR-HPV positive group the rates of cleanliness grade Ⅲ-Ⅳ,normal proportion of Lactobacillus,vaginal pH value≥4.6,vulvovaginal candidiasis and bacterial vaginosis were higher than those in the HR-HPV negative group(P<0.05),and cases of vaginal microbiota density++～+++and vaginal microbiota diversity++～+++were fewer than those in the HR-HPV negative group(P<0.05).Multivariate logistic regression analysis showed that the decreased proportion of normal Lactobacillus,vaginal pH value≥4.6,vulvovaginal candidiasis,and the rate of bacterial vaginosis were risk factors for HR-HPV infection after CKC treatment in HSIL patients,while vaginal microbiota density++～++++and vaginal microbiota diversity++～+++were protective factors(P<0.05).Conclusion The imbalance of vaginal microecology is related to HR-HPV infection after CKC in patients with HSIL.Clinically,the vaginal microecology after CKC should be regulated in a timely manner to promote the clearance of HR-HPV.