Effect analysis of applying high-quality service model to surgical nursing

BACKGROUND Surgical care of the hand plays a crucial role in the medical field,as problems with the hand can profoundly affect a patient's quality of life and function.In order to meet the needs of patients,improve patient satisfaction and improve treatment outcomes,high-quality service models have been introduced in the field of nursing.AIM To explore the effect analysis of applying high-quality service model to surgical nursing.METHODS We conducted a retrospective study of patients who underwent hand surgery at our hospital between 2019 and 2022,using a quality service model that included improved patient education,pain management,care team collaboration,and effective communication.Another group of patients received traditional care as a control group.We compared postoperative recovery,satisfaction,complication rate,and length of hospital stay between the two groups.Inferential statistics were used to compare the difference between the two groups by independent sample t test,Chi-square test and other methods to evaluate the effect of intervention measures.RESULTS Postoperative recovery time decreased from 17.8±2.3 d to 14.5±2.1 d,pain score decreased from 4.7±1.9 to 3.2±1.4,and hand function score increased from 78.4±7.1 to 88.5±6.2.In terms of patient satisfaction,the quality service model group scored 87.3±5.6 points,which was significantly higher than that of the traditional care group(74.6±6.3 points).At the same time,patients'understanding of medical information also improved from 6.9±1.4 to 8.6±1.2.In terms of postoperative complications,the application of the quality service model reduced the incidence of postoperative complications from 26%to 10%,the incidence of infection from 12%to 5%,and the incidence of bleeding from 10%to 3%.The reduction in these data indicates that the quality service model plays a positive role in reducing the risk of complications.In addition,the average hospital stay of patients in the quality service model group was shortened from 6.8±1.5 d to 5.2±1.3 d,and the hospitalization cost was also reduced from 2800±600 yuan to 2500±500 yuan.CONCLUSION Applying a quality service model to hand surgery care can significantly improve patient clinical outcomes,including faster recovery,less pain,greater satisfaction,and reduced complication rates.

Artificial dermis combined with skin grafting for the treatment of hand skin and soft tissue defects and exposure of bone and tendon

BACKGROUND The recovery time of hand wounds is long,which can easily result in chronic and refractory wounds,making the wounds unable to be properly repaired.The treatment cycle is long,the cost is high,and it is prone to recurrence and disability.Double layer artificial dermis combined with autologous skin transplantation has been used to repair hypertrophic scars,deep burn wounds,exposed bone and tendon wounds,and post tumor wounds.AIM To investigate the therapeutic efficacy of autologous skin graft transplantation in conjunction with double-layer artificial dermis in treating finger skin wounds that are chronically refractory and soft tissue defects that expose bone and tendon.METHODS Sixty-eight chronic refractory patients with finger skin and soft tissue defects accompanied by bone and tendon exposure who were admitted from July 2021 to June 2022 were included in this study.The observation group was treated with double layer artificial dermis combined with autologous skin graft transplantation(n=49),while the control group was treated with pedicle skin flap transplantation(n=17).The treatment status of the two groups of patients was compared,including the time between surgeries and hospital stay.The survival rate of skin grafts/flaps and postoperative wound infections were evaluated using the Vancouver Scar Scale(VSS)for scar scoring at 6 mo after surgery,as well as the sensory injury grading method and two-point resolution test to assess the recovery of skin sensation at 6 mo.The satisfaction of the two groups of patients was also compared.RESULTS Wound healing time in the observation group was significantly longer than that in the control group(P<0.05,27.92±3.25 d vs 19.68±6.91 d);there was no significant difference in the survival rate of skin grafts/flaps between the two patient groups(P>0.05,95.1±5.0 vs 96.3±5.6).The interval between two surgeries(20.0±4.3 d)and hospital stay(21.0±10.1 d)in the observation group were both significantly shorter than those in the control group(27.5±9.3 d)and(28.4±17.7 d),respectively(P<0.05).In comparison to postoperative infection(23.5%)and subcutaneous hematoma(11.8%)in the control group,these were considerably lower at(10.2%)and(6.1%)in the observation group.When comparing the two patient groups at six months post-surgery,the excellent and good rate of sensory recovery(91.8%)was significantly higher in the observation group than in the control group(76.5%)(P<0.05).There was also no statistically significant difference in two point resolution(P>0.05).The VSS score in the observation group(2.91±1.36)was significantly lower than that in the control group(5.96±1.51),and group satisfaction was significantly higher(P<0.05,90.1±6.3 vs 76.3±5.2).CONCLUSION The combination of artificial dermis and autologous skin grafting for the treatment of hand tendon exposure wounds has a satisfactory therapeutic effect.It is a safe,effective,and easy to operate treatment method,which is worthy of clinical promotion.

Prevalence of amblyopia in congenital blepharoptosis: a systematic review and Meta-analysis

AIM: To conduct a systematic review and Meta-analysis of the published literature to evaluate the pooled prevalence rate of amblyopia in patients with congenital ptosis.METHODS: We searched the PubMed, Embase, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang Data, and Chongqing VIP databases for studies reporting the prevalence of amblyopia in patients with congenital ptosis. The reference lists of relevant studies were scanned. Heterogeneity of effect sizes across studies was tested. We calculated prevalence ratios to compare prevalence estimates for different causes of amblyopia in patients with congenital ptosis, as well as for different geographical regions, year of publication and sample size in subgroup analyses. A systematic review and Meta-analysis were performed.RESULTS: We identified 29 eligible surveys with a total population of 2436. Prevalence rates of amblyopia ranged from 13.8% to 69%. We noted substantial heterogeneity in prevalence estimates for amblyopia in congenital ptosis(Cochran’s χ2 significant at P<0.0001; I2=90%). The pooled prevalence using random-effects models of 29 studies was 32.8%(95%CI: 27.3%-38.4%) in the overall population. Compared to the overall pooled prevalence, amblyopia prevalence was higher in studies in which only subjects with blepharophimosis syndrome were included.CONCLUSION: We confirm that nearly one-third of congenital ptosis patients are suffering from or at risk for amblyopia. Patients with blepharophimosis syndrome are more likely to develop amblyopia. The identificationand management of amblyopia should be integral to the treatment of congenital ptosis.

Polarization engineering in porous organic polymers for charge separation efficiency and its applications in photocatalytic aerobic oxidations

Photocatalytic aerobic oxidation reactions are largely governed by the efficiency of charge separation and subsequent reactive oxygen species(ROS) generation. Herein, we report a polarization engineering strategy to promote the charge separation and ROS generation efficiency by substituting the benzene unit with furan/thiophene in porous organic polymers(POPs). Benefiting from the extent of local polarization, the thiophene-containing POP(JNU-218) exhibits the best photocatalytic performance in aerobic oxidation reactions, with a yield much higher than those for the furan-containing POP(JNU-217) and the benzenecontaining POP(JNU-216). Experimental studies and theoretical calculations reveal that the increase of local polarization can indeed reduce the exciton binding energy, and therefore facilitate the separation of electron-hole pairs. This work demonstrates a viable strategy to tune charge separation and ROS generation efficiency by modulating the dipole moments of the building blocks in porous polymeric organic semiconductors.

Study on brain network function of the specific connection between Hégǔ(合谷LI4)and the facial-oral area

Objective:This study was designed to observe the effect of electroacupuncture at Hégǔ(合谷L14),or Hòuxī(后溪SI3) or Wàiguān(外关TE5) acupoints on the function of the brain regions of a healthy human,and to explore the neural information mechanism of a specific connection between LI4 and the facialoral area from the point of view of the brain function connection network.A further objective was to enrich knowledge of the specific connection between the body surface and the meridian route,and the specificity of acupoint effects.Methods:A total of 30 healthy volunteers were randomly assigned to LI4,SI3,and TE5 groups.The members of each group were stimulated with electroacupuncture,and their heads were scanned using fMRI.DPARSFA 2.4 and REST 1.8 software were used for data preprocessing and statistical analysis.The paired t-test was used within group and the double sample t-test was used for two-group comparisons.Results:In healthy people,left LI4 with electroacupuncture mainly caused a decrease of the functional connection of the right orofacial motor area of the brain,which remained decreased after removing the needle.When LI4 was compared with SI3 and TE5,LI4 caused a more significant decline in the functional connection of the right side of the brain during acupuncture.Conclusions:Acupuncture at LI4 has a significant effect on the function of the face-and mouth-related areas in the brain,and there is a continuous effect.It is suggested that LI4 and the face and mouth have a specific relationship in the brain,which is most obvious during acupuncture.

Structural Optimization of Electromagnetic Swirling Flow in Nozzle of Slab Continuous Casting

During the slab continuous casting process, the flow field of molten steel in the mold plays a decisive role in the quality ofthe slab. In this paper, electromagnetic swirling flow in nozzle technology is proposed to control the flow field in mold.This technology can drive molten steel to rotate inside the submerged entry nozzle by electromagnetic force, therebycontrolling the flow field. This research shows that it can reduce the impact of molten steel on the bottom of nozzle andpartly reduce the negative pressure at the upper part of nozzle outlet which is even eliminated by optimizing the structureand angle of nozzle. The area of heat flux of the mold wall becomes larger, and the crest value of heat flux gets lower thanthat without swirling in nozzle and any nozzle optimization. The meniscus fluctuates smoothly, and the flow velocity at thetop surface is within a reasonable range. The temperature field distribution in the mold is uniform which was beneficial tothe growth of equiaxed crystal and decreased element segregation.

Influence of Joint EMSFN and M-EMS on Fluid Flow in the Mold During Continuous Casting

Homogenization of physical properties and the chemical composition through the control of liquid metal flow is essentialduring the continuous casting production of billets. This work was aimed at obtaining improved finished products viacontinuous casting that implements two magnetic fields. These fields were realized via two electromagnetic stirringprocesses implemented in a single process： one in the nozzle and one in the mold. The qualitative effects of applyingdouble electromagnetic stirring （EMS） were verified through numerical simulation of 178 mm × 178 mm square billetsexposed to double electromagnetic fields during the continuous casting process. The accuracy of the numerical calculationswas verified via physical experiments. In addition, the final simulation results were compared with the intermediate results,to determine the true effects of different EMS on the metal flow in the mold. The results revealed that casting using EMSwith different directions of magnetic field in the mold and the nozzle has the best effect on the distribution of the fluid flowand minimal influence on the stability of the meniscus and yields the minimum metal-jet penetration into the mold.

Coil Ambient Temperature and Its Influence on the Formation of Blocking Layer in the Electromagnetic Induction-Controlled Automated Steel-Teeming System

Ambient temperature of induction coil is an important factor to influence the implementation of the electromagnetic induction-controlled automated steel-teeming(EICAST) technology. Meanwhile, it also affects the formation of Fe–C alloy blocking layer, which determines the length and installation position of induction coil. An experimental platform was designed to imitate actual working conditions in a ladle with the EICAST system. Ambient temperature of induction coil under high-temperature condition was measured to verify the accuracy of numerical result. After containing molten steel for 120 min and steel teeming for 40 min, the ambient temperature on the upper side of induction coil is 791 °C. In addition, the position of blocking layer in a 110 t ladle was measured by sand-collection and steel-pour methods, and the criterion temperatures of blocking layer in numerical simulation process were corrected. When the refining temperature is1600 °C and the containing time of molten steel is 120 min, the thickness of blocking layer is 130 mm, and the distance between the upper surface of blocking layer and the upper surface of nozzle brick is 154 mm. When the criterion temperatures are 919 °C and 428 °C, the numerical results can be used to confirm the position of blocking layer and the installation position of induction coil.