Management Measures for Preventing Postoperative Incision Infections in General Surgery at Primary Hospitals

Objective:To analyze the management measures and effects of preventing postoperative incision infections in the general surgery department of primary hospitals.Methods:Forty-nine surgical patients with 11 healthcare workers who were admitted to the general surgery department of the primary hospital between August 2021 and August 2022 were selected as the routine group for routine incision infection management.Forty-nine surgical patients with 11 healthcare workers admitted to the same department between September 2022 and September 2023 were selected as the prevention group for prophylactic management of postoperative incision infections.The incision infection rate,knowledge,attitude,and practice(KAP)scores,and management satisfaction of the patients as well as the management skill scores of healthcare workers were compared between the two groups.Results:The rate of postoperative incision infection in the prevention group was lower than that in the routine group;after implementing management measures,patients in the prevention group had higher KAP scores than those in the routine group;patients in the prevention group were more satisfied with the management than those in the routine group;and healthcare workers in the prevention group had higher scores than those in the routine group,with P<0.05 for the comparison between the groups.Conclusion:The implementation of preventive management for general surgery patients in primary hospitals can reduce the incidence of postoperative incision infection and improve the KAP of patients,with higher management satisfaction.It can also enhance the management skills of healthcare workers,thus improving their overall management level.

HealthMeasures患者报告结局报告清单的解读

美国匹兹堡大学和HealthMeasures指导委员会及PROMIS健康组织标准委员会共同发表了HealthMeasures患者报告结局报告清单,旨在促进不同患者报告结局测量工具的标准化报告,帮助研究人员提高工具报告质量及结果解释的准确性,进一步改善跨研究间的比较分析。本文对HealthMeasures患者报告结局报告清单的主要内容进行介绍和解读,以期为中国患者报告结局研究者提供参考和借鉴。

Application of Specialized Group Management in the Quality Control of Perioperative Nursing

Objective:To explore the role of specialized group management in the quality control of perioperative nursing.Methods:45 surgical nurses from our hospital were selected as the research subjects.Traditional operating room management was adopted from July 2019 to June 2020,and specialized group management was adopted from July 2020 to June 2021.The surgeon’s satisfaction,surgical nurses’core professional competence,and surgical patients’satisfaction were obtained through surveys and the results were analyzed.Results:Surgeon satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Besides,surgical nurses’core professional competency scores before the implementation of specialized group management were significantly lower than after its implementation(P<0.05).Lastly,surgical patients’satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Conclusion:Specialized group management helps to improve the quality of perioperative care and should be applied in clinical practice.

Defining the association between the prolonged operative time and 90-day complications in patients undergoing radical cystectomy

Objective:Radical cystectomy is a complex lengthy procedure associated with postoperative morbidity.We aimed to assess the operative time(OT)in patients undergoing radical cystectomy and its impact on 90-day postoperative complications and readmission rates.Methods:The retrospective cohort study included 296 patients undergoing radical cystectomy and urinary diversion from May 2010 to December 2018 in our institution.The OT of 369 min was set as a cutoff value between short and long OT groups.The primary outcome was 90-day postoperative complication rates.Secondary outcomes were gastrointestinal recovery time,length of hospital stay,and 90-day readmission rates.Results:The overall incidence of 90-day postoperative complications was 79.7%where 43.2%representing low-grade complications according to the ClavieneDindo classification(Grade 1 and Grade 2),and 36.5%representing high-grade complications(Grade3).Gastrointestinal tract and infectious complications are the most common complications in our data set(45.9%and 45.6%,respectively).On multivariable analysis,prolonged OT was significantly associated with odds of high-grade complications(odds ratio 2.340,95%confidence interval 1.288e4.250,p=0.005).After propensity score-matched analysis,a higher incidence of major complications was identified in the long OT group 55(51.4%)compared to 35(32.7%)in the short OT group(p=0.006).A shorter gastrointestinal tract recovery time was noticed in the short OT group(p=0.009).Prolonged OT was associated with a higher 90-day readmission rate on univariate and multivariate analyses(p<0.001,p=0.001,respectively).

Practice of Barrier Measures against COVID-19 Among Diabetic People Followed at Departmental University Hospital Center Ouémé-Plateau, Benin, in 2021

Introduction: COVID-19 is a pandemic disease caused by the coronavirus SARS-COV2 appeared in China in 2019. The aim of the study was to evaluate the practice of barrier measures against COVID-19 and to identify associated factors among diabetics followed at Departmental University Hospital Center Ouémé-Plateau, Benin, in 2021. Methods: This was a cross-sectional study conducted from June to August 2021, including diabetics aged 18 and over, hospitalized or received for medical visits in the department of medicine at the target hospital. Data were collected during an interview with each participant thanks to a questionnaire. “Good practice” was defined as regular practice of at least two of three barrier measures: hand washing, physical distancing and mask-wearing. Results: A total of 110 diabetics were included with a female predominance (55.5%) and a mean age of 57 ± 11.3 years. Among them, 89.1% washed their hands, 41.8% respected physical distancing and 12.7% wore a mask. The proportion of good practice was 47.3%. Only 5 practiced the three barrier measures. Only age group was associated with good practice. Conclusion: The study showed a low proportion of good practice of barrier measures against COVID-19 among diabetic people surveyed. It is important to continue the action for COVID-19 prevention among diabetic people in the targeted hospital and in other hospitals in Benin.

Socio-scientific quantification of the comprehensive benefits of debris flow mitigation measures for villages in western Sichuan, China

Debris flow hazards seriously threaten thesafety and sustainable development of mountainousareas. Numerous debris flow mitigation measures havebeen implemented worldwide;however, acomprehensive assessment of the specific disasterreduction effects of these measures and their economic,social and ecological benefits is yet to be performed.The western region of Sichuan Province frequentlysuffers from geohazards such as debris flow, and thegovernment has adopted many mitigation measures.This study assessed the benefits of debris flowmitigation measures and identified the key influencingfactors via a field-based study conducted in 81 villagesin western Sichuan province, China. A framework forthe evaluation of the benefits of rural debris flowmitigation measures was constructed andquantitatively evaluated using a survey. Snowballsampling was performed to recruit 81 village leadersand 468 farmers. The results showed that managementand engineering measures were the main methodsused to mitigate debris flow;ecological measures wereauxiliary. The average satisfaction scores of farmers forthese three types of measures were 4.07, 3.90, and 3.56,respectively (as measured on a five-point Likert scale).In contrast, in terms of the benefits of these mitigationmeasures, only a small proportion of villages (11.11%)obtained a high level of comprehensive benefits fromthe debris flow mitigation measures, while the majority(88.89%) received medium to low-level benefits. Toimprove this situation, we further studied and foundthat the main factors that restricted villages fromachieving high-level comprehensive benefits were theunpredictable nature of debris flows, labour forceoutflow and remoteness. Effective control measures, agood economic environment and strong governmentassistance were reported as crucial factors forimproving these comprehensive benefits. This studyprovides socio-scientific references for decisionmakingon rural debris flow mitigation measures while keeping villages at the centre of economic development.

Adherence to Physical Measures during the SARS-COV2 Pandemic by Haemodialysis Patients in a Burkina Faso Tertiary Hospital: A Cross-Sectional Survey

Context: COVID-19 can spread rapidly in haemodialysis centres, leading to fatal outcomes. Implementing physical measures is crucial in limiting the spread of infection. Aims: To assess adherence to physical measures against SARS-Cov2 in haemodialysis patients. Methods and Material: From 13 to 19 July 2021, we administered the questionnaire to haemodialysis patients during or immediately after the dialysis session. The dependent variables were adherence to wearing masks, hand washing outside the dialysis centre, social distancing of at least 1.5 meters, and cough and sneeze hygiene. Statistical Analysis Used: Data were analyzed using Epi info software;descriptive statistics were presented as mean, headcount, and percentage;related factors were determined by multi-logistic regression. The significance level was 5%. The Health Research Ethics Committee approved the research protocol. Results: 142 patients were included (mean age: 42.5 ± 14 years). Wearing masks, hand-washing, social distancing, and coughing and sneezing hygiene were observed by 88%, 75%, 47%, and 60% of patients, respectively. Conclusion: Wearing masks was the most respected physical measure, while social distancing was the least respected.

Clinical effect of operative vs nonoperative treatment on humeral shaft fractures:Systematic review and meta-analysis of clinical trials

BACKGROUND Whether operation is superior to non-operation for humeral shaft fracture remains debatable.We hypothesized that operation could decrease the nonunion and reintervention rates and increase the functional outcomes.AIM To compare the clinical efficacy between operative and nonoperative approaches for humeral shaft fractures.METHODS We searched the PubMed,Web of Science,ScienceDirect,and Cochrane databases from 1990 to December 2023 for clinical trials and cohort studies comparing the effects of operative and conservative methods on humeral shaft fractures.Two investigators independently extracted data from the eligible studies,and the other two assessed the methodological quality of each study.The quality of the included studies was assessed using the Cochrane risk bias or Newcastle-Ottawa Scale.The nonunion,reintervention and the overall complications and functional scores were pooled and analyzed using Review Manager software(version 5.3).RESULTS A total of four randomized control trials and 13 cohort studies were included,with 1285 and 1346 patients in the operative and nonoperative groups,respectively.Patients in the operative group were treated with a plate or nail,whereas those in the conservative group were managed with splint or functional bracing.Four studies were assessed as having a high risk of bias,and the other 13 were of a low risk of bias according to the Newcastle-Ottawa Scale or Cochrane risk bias tool.The operative group had a significantly decreased rate of nonunion[odds ratio(OR)0.30;95%CI:0.23 to 0.40,reintervention(OR:0.33;95%CI:0.24 to 0.47),and overall complications(OR:0.62;95%CI:0.49 to 0.78)].The pooled effect of the Disabilities of Arm,Shoulder,and Hand score showed a significant difference at 3[mean difference(MD)-8.26;95%CI:-13.60 to-2.92],6(MD:-6.72;95%CI:-11.34 to-2.10),and 12 months(MD:-2.55;95%CI:-4.36 to-0.74).The pooled effect of Visual Analog Scale scores and the Constant-Murley score did not significantly differ between the two groups.CONCLUSION This systematic review and meta-analysis revealed a trend of rapid functional recovery and decreased rates of nonunion and reintervention after operation for humeral shaft fracture compared to conservative treatment.

Impact of Migrant Populations on Tuberculosis Rates in Saudi Arabia: Assessing How Migration Patterns Affect TB Incidence and Control Measures: A Narrative Review

This research focuses on the effects of migration on the TB infection rate and its prevention in Saudi Arabia, which has a large number of expatriates from TB-affected countries. Despite, based on the current global statistics of TB occurrence, it is evident that the national incidence of TB has reduced from 10.55 per 100,000 in 2015 to 8.36 per 100,000 in 2019;despite this, there are still some difficulties because migrants bring new strains of Mycobacterium tuberculosis. Hindrances, including language barriers and perceived immigration status, hinder patients from seeking medical attention or doctors from diagnosing diseases. Each patient and each cultural group need special attention to public health, enhancing living circumstances, and health care support. Community participation, inclusion of TB control programs into functional healthcare facilities, and the functioning of TB programs need to be stressed to address TB issues. Considering the focus on social, economic, and cultural approaches, the country can make severe advancements in TB control and population protection. This holistic analysis is critical for a long-term effective strategy to combat TB in the Kingdom.

On the Polygonal Wear Evolution of Heavy-Haul Locomotive Wheels due to Wheel/Rail Flexibility and Its Mitigation Measures

Wheel polygonal wear can immensely worsen wheel/rail interactions and vibration performances of the train and track,and ultimately,lead to the shortening of service life of railway components.At present,wheel/rail medium-or high-frequency frictional interactions are perceived as an essential reason of the high-order polygonal wear of railway wheels,which are potentially resulted by the flexible deformations of the train/track system or other external excitations.In this work,the effect of wheel/rail flexibility on polygonal wear evolution of heavy-haul locomotive wheels is explored with aid of the long-term wheel polygonal wear evolution simulations,in which different flexible modeling of the heavy-haul wheel/rail coupled system is implemented.Further,the mitigation measures for the polygonal wear of heavy-haul locomotive wheels are discussed.The results point out that the evolution of polygonal wear of heavy-haul locomotive wheels can be veritably simulated with consideration of the flexible effect of both wheelset and rails.Execution of mixed-line operation of heavy-haul trains and application of multicut wheel re-profiling can effectively reduce the development of wheel polygonal wear.This research can provide a deep-going understanding of polygonal wear evolution mechanism of heavy-haul locomotive wheels and its mitigation measures.

Value of improved nursing measures and enhanced nursing management to reduce the occurrence of adverse events in pediatric infusion

BACKGROUND Intravenous infusion is a common method of drug administration in clinical practice.Errors in any aspect of the infusion process,from the verification of medical orders,preparation of the drug solution,to infusion by nursing staff,may cause adverse infusion events.AIM To analyzed the value of improving nursing measures and enhancing nursing management to reduce the occurrence of adverse events in pediatric infusion.METHODS The clinical data of 130 children who received an infusion in the pediatric department of our hospital from May 2020 to May 2021 were analyzed and divided into two groups according to the differences in nursing measures and nursing management:65 patients in the control group received conventional nursing and nursing management interventions,while 65 patients in the observation group received improved nursing measure interventions and enhanced nursing management.The occurrence of adverse events,compliance of children,satisfaction of children’s families,and complaints regarding the transfusion treatment were recorded in both groups.RESULTS The incidence of fluid extravasation and infusion set dislodgement in the observation group were 3.08%and 1.54%,respectively,which were significantly lower than 12.31%and 13.85%in the control group(P<0.05),while repeated punctures and medication addition errors in the observation group were 3.08%and 0.00%,respectively,which were lower than 9.23%and 3.08%in the control group,but there was no significant difference(P>0.05).The compliance rate of children in the observation group was 98.46%(64/65),which was significantly higher than 87.69%(57/65)in the control group,and the satisfaction rate of children’s families was 96.92%(63/65),which was significantly higher than 86.15%(56/65)in the control group(P<0.05).The observation group did not receive any complaints from the child’s family,whereas the control group received four complaints,two of which were due to the crying of the child caused by repeated punctures,one due to the poor attitude of the nurse,and one due to medication addition errors,with a cumulative complaint rate of 6.15%.The cumulative complaint rate of the observation group was significantly lower than that of the control group(P<0.05).CONCLUSION Improving nursing measures and enhancing nursing management can reduce the incidence of fluid extravasation and infusion set dislodgement in pediatric patients,improve children’s compliance and satisfaction of their families,and reduce family complaints.

Association between operative position and postoperative nausea and vomiting in patients undergoing laparoscopic sleeve gastrectomy

BACKGROUND Bariatric surgery is one of the most effective ways to treat morbid obesity,and postoperative nausea and vomiting(PONV)is one of the common complications after bariatric surgery.At present,the mechanism of the high incidence of PONV after weight-loss surgery has not been clearly explained,and this study aims to investigate the effect of surgical position on PONV in patients undergoing bariatric surgery.AIM To explore the effect of the operative position during bariatric surgery on PONV.METHODS Data from obese patients,who underwent laparoscopic sleeve gastrectomy(LSG)in the authors’hospital between June 2020 and February 2022 were divided into 2 groups and retrospectively analyzed.Multivariable logistic regression analysis and the t-test were used to study the influence of operative position on PONV.RESULTS There were 15 cases of PONV in the supine split-leg group(incidence rate,50%)and 11 in the supine group(incidence rate,36.7%)(P=0.297).The mean operative duration in the supine split-leg group was 168.23±46.24 minutes and 140.60±32.256 minutes in the supine group(P<0.05).Multivariate analysis revealed that operative position was not an independent risk factor for PONV(odds ratio=1.192,95%confidence interval:0.376-3.778,P=0.766).CONCLUSION Operative position during LSG may affect PONV;however,the difference in the incidence of PONV was not statistically significant.Operative position should be carefully considered for obese patients before surgery.

Influencing factors and preventive measures of infectious complications after intestinal resection for Crohn’s disease

The incidence of Crohn’s disease(CD)has increased in recent years,with most patients requiring intestinal resection.Complications after intestinal resection for CD can lead to poor prognosis and recurrence,among which infectious complic-ations are the most common.This study aimed to investigate the common risk factors,including medications,preoperative nutritional status,surgery-related factors,microorganisms,lesion location and type,and so forth,causing infectious complications after intestinal resection for CD,and to propose corresponding preventive measures.The findings provided guidance for identifying suscept-ibility factors and the early intervention and prevention of infectious complic-ations after intestinal resection for CD in clinical practice.

Influence of Lightning Disaster on Cities and Lightning Defense Measures

Under the influence of special terrain and climatic conditions,lightning weather in Ulanqab City is more frequent from June to August,and lightning disaster has become one of the important tasks of disaster prevention and mitigation.In this paper,based on the characteristics of lightning weather in Ulanqab City,the impact of lightning disaster on the city was analyzed,and lightning protection measures,such as strengthening supervision of lightning protection safety,establishing a long-term lightning protection mechanism,doing a good job in lightning protection construction and detection in key places,and further improving public awareness of lightning protection,were put forward to reduce and avoid urban lightning disasters as much as possible and ensure urban safety.

Non-steroidal anti-inflammatory drugs in postoperative hand fracture management:Do they positively or negatively impact recovery?

This editorial explores the impact of non-steroidal anti-inflammatory drugs(NSAIDs)on postoperative recovery in hand fracture patients,amidst shifting pain management strategies away from opioids due to their adverse effects.With hand fractures being significantly common and postoperative pain management crucial for recovery,the potential of NSAIDs offers a non-addictive pain control alternative.However,the controversy over NSAIDs'effects on bone healing—stemming from their Cyclooxygenase-2 inhibition and associated risks of fracture non-union or delayed union—necessitates further investigation.Despite a comprehensive literature search,the study finds a lack of specific research on NSAIDs in postoperative hand fracture management,highlighting an urgent need for future studies to balance their benefits against possible risks.

On Adaptation Measures to Solve Tel-Aviv’s Environmental Problems with “Sunny Rain”

Adaptation measures were proposed using“Sunny Rain”to solve Tel Aviv’s environmental problems to cool the air in the city and save humanity from climate catastrophe and fight air pollution;the Yarkon,“Tel Aviv’s main river”will no longer be a dirty ditch;the fog from Ben-Gurion Airport was cleaned;neighborhoods,parks,around Tel Aviv were greened and all green spaces were irrigated with“Sunny Rain”.

Whole petroleum system in Jurassic coal measures of Taibei Sag in Tuha Basin,NW China

Based on the latest results of near-source exploration in the Middle and Lower Jurassic of the Tuha Basin,a new understanding of the source rocks,reservoir conditions,and source-reservoir-cap rock combinations of the Jurassic Shuixigou Group in the Taibei Sag is established using the concept of the whole petroleum system,and the coal-measure whole petroleum system is analyzed thoroughly.The results are obtained in three aspects.First,the coal-measure source rocks of the Badaowan Formation and Xishanyao Formation and the argillaceous source rocks of the Sangonghe Formation in the Shuixigou Group exhibit the characteristics of long-term hydrocarbon generation,multiple hydrocarbon generation peaks,and simultaneous oil and gas generation,providing sufficient oil and gas sources for the whole petroleum system in the Jurassic coal-bearing basin.Second,multi-phase shallow braided river delta–shallow lacustrine deposits contribute multiple types of reservoirs,e.g.sandstone,tight sandstone,shale and coal rock,in slope and depression areas,providing effective storage space for the petroleum reservoir formation in coal-measure strata.Third,three phases of hydrocarbon charging and structural evolution,as well as effective configuration of multiple types of reservoirs,result in the sequential accumulation of conventional-unconventional hydrocarbons.From high structural positions to depression,there are conventional structural and structural-lithological reservoirs far from the source,low-saturation structural-lithological reservoirs near the source,and tight sandstone gas,coal rock gas and shale oil accumulations within the source.Typically,the tight sandstone gas and coal rock gas are the key options for further exploration,and the shale oil and gas in the depression area is worth of more attention.The new understanding of the whole petroleum system in the coal measures could further enrich and improve the geological theory of the whole petroleum system,and provide new ideas for the overall exploration of oil and gas resources in the Tuha Basin.

A Boost to Inbound Tourism China sees surge in foreign travellers following introduction of visa-free transit measures

One of the viral terms on Chinese social media these days-“city bu city”–was actually created by a foreign tourist.The tourist,a blogger,used the term,which literally means city or not city,in a short video he filmed while visiting the Great Wall,wondering whether the place is like a fashionable big city.

Implementation Measures for Fire Work Safety in Gas Area of Metallurgical Enterprises

It is an important task to control the dangerous operation of gas fire and reduce the occurrence of gas fire and explosion accidents in ensuring gas operation safety in metallurgical enterprises.Combined with the require-ments of current laws,standards and practical experience,the key points in fire safety management and control are analyzed to solve the gas fire safety problems.

Advances in nonpharmacologic interventions for operative puncture pain in children

Venipuncture is an indispensable nursing procedure for intravenous infusion,but it is also an invasive procedure that is highly resisted by hospitalised children due to pain or fear.Non-pharmacological interventions are widely used in clinical practice due to their low cost,low risk and simplicity.This article provides a review with the aim of providing a reference for the selection of optimal analgesic interventions in the future.