Table of Content

28 June 2019, Volume 8 Issue 2 Previous Issue    Next Issue

Original article

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Meta analysis of efficacy and safety of FOLFOX regimen and XELOX regimen in patients with advanced colon cancer CHEN Jinbao, QIU Yanyan, XU Ke, HE Xue, WU Honglei, ZENG Yijun, YIN Peihao 2019, 8 (2):  73-83.  doi: 10.3969/j.issn.2095-378X.2019.02.001 Abstract ( 376 )   PDF (1849KB) ( 515 )   Save Objective To evaluate the efficacy and safety of FOLFOX regimen and XELOX regimen in the treatment of advanced colon cancer.Methods The following five databases were searched: VIP Database, Chinese BioMedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Data, and PubMed.The quality assessment and meta analysis of the clinical studies meeting the inclusion criteria were performed using RevMan 5.3 software.Results A total of 12 articles were included in the study, with 1 614 colon cancer patients, 801 to the FOLFOX group and 813 to the XELOX group.There was no significant difference in overall response, complete response, partial response, overall survival, and progression-free survival between the two regimens.The incidence rate of grade Ⅲ/Ⅳ hand-foot syndrome caused by XELOX regimen (RR=0.2, 95% CI 0.08-0.51, P<0.001) was higher than that by FOLFOX regimen, while the grade Ⅲ/Ⅳ neutropenia caused by FOLFOX regimen (RR=5.47, 95%CI 3.42-8.76, P<0.001) was higher than that by XELOX regimen.Conclusion The efficacy of FOLFOX regimen on advanced colon cancer is similar to that of XELOX regimen, but it is worth noting that the risk of grade Ⅲ/Ⅳ hand-foot syndrome caused by XELOX regimen is higher, while the risk of grade Ⅲ/Ⅳ neutropenia caused by FOLFOX regimen is higher. References | Related Articles | Metrics

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Effect of minimally invasive catheter drainage on quality of life in patients with cerebral hemorrhage YANG Qiuxiong, CAI Fenzhong 2019, 8 (2):  84-87.  doi: 10.3969/j.issn.2095-378X.2019.02.002 Abstract ( 145 )   PDF (849KB) ( 404 )   Save Objective To explore the effect of minimally invasive catheter drainage on the quality of life in patients with cerebral hemorrhage.Methods A total of 200 cases of cerebral hemorrhage admitted to our hospital from January 2014 to December 2018 were selected for study, and divided according the surgical Methods into control group (n=100, patients who were treated with traditional craniotomy) and study group (n=100, patients who were treated with minimally invasive catheter drainage).Neurologic deficit and quality of life of the two groups were evaluated, and postoperative complications were recorded.Results Before treatment, the scores of NIHSS and SS-QoL in the two groups were similar, with no significant difference (P>0.05).After treatment, the NIHSS scores of the two groups both decreased, while the SS-QoL scores of the two groups both increased.However, the study group showed greater changes (P<0.05).Meanwhile, the incidence rate of postoperative complications was 21.00% in the control group and 8.00% in the study group, and there was a significant difference between the two groups (P<0.05).Conclusion Minimally invasive catheter drainage surgery for cerebral hemorrhage can improve the quality of life and cerebral nerve function of patients, and is worthy of wide clinical application. References | Related Articles | Metrics

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Clinical study on establishment of three-order stereopsis after primary exotropia surgery in children by internet-based neuroplasticity learning PENG Jing 2019, 8 (2):  88-90.  doi: 10.3969/j.issn.2095-378X.2019.02.003 Abstract ( 146 )   PDF (746KB) ( 510 )   Save Objective To investigate the clinical effect of internet-based neuroplasticity learning on the establishment of three-order stereopsis after primary exotropia surgery in children.Methods A total of 62 patients were divided into two groups using internet-based neuroplasticity learning and virtual reality database system: training group (31 cases) and control group (31 cases, i.e.non-training group).All the patients were examined for three-order stereopsis by using the “computer platform-based visual perception examination system” and for stereoscopic recovery half a year after the operation.Results There was no significant difference in three-order stereopsis between the two groups of patients one week after the operation (P>0.05).The children with establishment of the first- and second-order stereopsis in the training group was significantly more than the chilren in the control group (P<0.05), while the children without establishment of three-order stereopsis in the control group was significantly more than the chilren in the training group (P<0.05).Conclusion The neuroplasticity learning based on the internet is helpful to the establishment of three-order stereopsis in children after exotropia surgery, but the stereopsis of the patients who do not use the approach has no obvious improvement. References | Related Articles | Metrics

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Clinical effect of nasal endoscopy via anterior lacrimal recess approach on mycotic nasosinusitis FU Run 2019, 8 (2):  91-93.  doi: 10.3969/j.issn.2095-378X.2019.02.004 Abstract ( 174 )   PDF (796KB) ( 389 )   Save Objective To discuss the efficacy of nasal endoscopy via anterior lacrimal recess approach on mycotic nasosinusitis.Methods Seventy patients with mycotic nasosinusitis treated from May 2017 to May 2018 in our hospital were selected and randomly assigned to middle meatal antrostomy group (n=35) and anterior lacrimal recess group (n=35).The efficacy was compared.Results Compared with the middle meatal antrostomy group, the anterior lacrimal recess group showed less intraoperative blood loss, shorter hospitalization time, lower and pain scores, better clinical effect, as well as lower complication rate and recurrence rate (P＜0.05).Conclusion The nasal endoscopy via anterior lacrimal recess approach for the treatment of mycotic nasosinusitis can remarkably increase clinical effect, promote fast recovery, and reduce complications.It is worthy of clinical promotion. References | Related Articles | Metrics

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Clincial study on relationship between upper gastrointestinal bleeding and Helicobacter pylori infection in patients with liver cirrhosis ZHANG Dongwei, YANG Changqing 2019, 8 (2):  94-96.  doi: 10.3969/j.issn.2095-378X.2019.02.005 Abstract ( 145 )   PDF (755KB) ( 373 )   Save Objective To investigate the relationship between upper gastrointestinal bleeding and Helicobacter pylori (H.pylori) infection in patients with liver cirrhosis.Methods Clinical data of 342 cases of liver cirrhosis from January 2013 to December 2017 were retrospectively analyzed.H.pylori infection, esophageal varices in the fundus of the stomach, and peptic ulcer were analyzed.Results The rate of upper gastrointestinal bleeding in the H.pylori positive group (43.93%) was significantly higher than that in the H.pylori negative group (34.72%) (P<0.05).The rate of peptic ulcer in the H.pylori positive group (54.02%) was significantly higher than that in the H.pylori negative group (37.5%) (P<0.05).Conclusion H.pylori infection and upper gastrointestinal bleeding are correlated in the patients of liver cirrhosis.Eradication of H.pylori infection may reduce upper gastrointestinal bleeding in patients with liver cirrhosis. References | Related Articles | Metrics

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Clinical value of color Doppler ultrasound in early diagnosis and prediction of postoperative ritality of testicular torsion ZHANG Bing, WANG Xiuyan 2019, 8 (2):  97-101.  doi: 10.3969/j.issn.2095-378X.2019.02.006 Abstract ( 118 )   PDF (6876KB) ( 210 )   Save Objective To investigate the clinical value of color Doppler ultrasound (CDU) in the early diagnosis of testicular torsion and postoperative vitality prediction.Methods Fifty patients with testicular torsion were diagnosed by color Doppler ultrasound before operation to determine the maximum diameter, peak systolic velocity (PSV), and resistance index (RI) of both affected and normal testicles, and to divide the preoperative vitality of affected testicles into 1-4 levels according to the ultrasound manifestations and blood flow supply.Operation Methods were determined according to the preoperative vitality of testicles.According to the testicular volume ratio (C) and CDU results, the postoperative vitality of testicles was divided into A-C level, A-B levels indicating testicular survival and C-level indicating testicular atrophy.Results The ultrasound diagnosis Results of 45 cases were consistent with the Results of operation, with an accuracy rate of 90%.The maximum diameter of the affected testicles [(5.2±1.2) cm] was larger than that of the normal testicles [(3.6±0.6) cm], the PSV of the affected testicles [(2.9±1.9) cm/s] was higher than that of the normal testicles [(7.8±2.2) cm/s], and the RI of the affected testicles (0.69±0.06) was higher than the normal testicles (0.48±0.03,P<0.05).Respectively 5 cases received testicular torsion resection and 40 cases retained testicles by testicular torsion reduction.There were 20 cases with A level vitality of testicles, whose preoperative vitality of testicles were graded into level 1 (n=8), level 2 (n=10), and level 3 (n=2); 17 cases with B level vitality of testicles, whose preoperative vitality of testicles were graded in to level 2 (n=1) and level 3 (n=16); and 3 cases with C level vitality of testicles, whose preoperative vitality of testicles were graded into level 3 (n=2) and level 4 (n=1).There was a significant correlation between the preoperative vitality of testicles and the postoperative follow-up vitality of testicles (r=0.824, P<0.001).Conclusion CDU is highly sensitive and specific to the early diagnosis of testicular torsion, and has important value in predicting the vitality of torsional testis after reduction. References | Related Articles | Metrics

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Clinical observation on segmental dissection and preservation of skin flaps in treatment of severe mixed hemorrhoids XU Wenye 2019, 8 (2):  102-105.  doi: 10.3969/j.issn.2095-378X.2019.02.007 Abstract ( 168 )   PDF (766KB) ( 409 )   Save Objective To observe the effect of segmental dissection and preservation of skin flaps on severe mixed hemorrhoids.Methods A total of 72 patients with mixed hemorrhoids of grade Ⅲ and Ⅳ were randomly divided into experimental group and control group, with 36 cases in each group.The experimental group received segmental dissection and preservation of skin flaps, while the control group received traditional external dissection and internal ligation.The operation time, intraoperative bleeding volume, postoperative pain, local edema, healing time, and surgical satisfaction of the two groups were recorded.Results The effective rates of both groups were 100%, without statistical difference.There were 4 cases of anal stenosis in the control group and no anal stenosis case in the experimental group, with statistical difference.The experimental group showed less intraoperative bleeding volume, lower VAS pain score, lower local edema score, shorter wound healing time, higher satisfaction, and longer operation time than the control group, with statistical differences.Conclusion The clinical effect of segmental dissection and preservation of skin flaps on severe mixed hemorrhoids deserves popularizing. References | Related Articles | Metrics

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Efficacy of hemorrhoid artery ligation combined with rubber band ligation on severe mixed hemorrhoids in senior patients HUANG Wei, ZHOU Acheng, KONG Ping 2019, 8 (2):  106-108.  doi: 10.3969/j.issn.2095-378X.2019.02.008 Abstract ( 152 )   PDF (754KB) ( 477 )   Save Objective To investigate the efficacy of hemorrhoid artery ligation combined with rubber band ligation on severe mixed hemorrhoids in senior patients.Methods Sixty senior patients with severe mixed hemorrhoids from February 2017 to February 2019 were selected and randomly divided into observation group (30 cases) and control group (30 cases).The control group took rubber band ligation, and the observation group was given hemorrhoid artery ligation combined with rubber band ligation.The efficacy and complications were compared between the two groups.Results The effective rate of the observation group was higher than that of the control group, and the incidence rate of complications of the observation group was lower than that of the control group (P<0.05).Conclusion Hemorrhoid artery ligation combined with rubber band ligation are effective in treatment of severe mixed hemorrhoids in senior patients, as it can decrease complications with high safety. References | Related Articles | Metrics

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Effect of sevoflurane combined with remifentanil anesthesia on stress response and early cognitive function in patients with laparoscopic hysterectomy ZHAO Yuchao, CHEN Ping, YU Deshui, CHEN Kui 2019, 8 (2):  109-111.  doi: 10.3969/j.issn.2095-378X.2019.02.009 Abstract ( 151 )   PDF (757KB) ( 410 )   Save Objective To investigate the effect of sevoflurane combined with remifentanil anesthesia in patients with laparoscopic hysterectomy.Methods The clinical data of 86 patients with laparoscopic hysterectomy from February 2016 to March 2018 were retrospectively analyzed.The cases were divided into observation group (sevoflurane combined with remifentanil anesthesia, 43 cases) and control group (propofol combined with remifentanil anesthesia, 43 cases) according to anesthesia regimens.The stress response and cognitive function were compared between the two groups.Results After pneumoperitoneum for 30 min and at the end of surgery, the epinephrine, cortisol, and heartrate of the observation group were lower than those of the control group, but the postoperative 1d MMSE score of the observation group was higher than that of the control group (P<0.05).Conclusion Sevoflurane combined with remifentanil anesthesia for patients with laparoscopic hysterectomy can effectively relieve surgical stress response, and have less effect on cognitive function. References | Related Articles | Metrics

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Clinical analysis on laparoscopic appendectomy for acute appendicitis DUAN Jun 2019, 8 (2):  112-114.  doi: 10.3969/j.issn.2095-378X.2019.02.010 Abstract ( 140 )   PDF (753KB) ( 454 )   Save Objective To investigate the effect of laparoscopic appendectomy on acute appendicitis.Methods From January 2016 to December 2018, 55 acute appendicitis patients treated with laparoscopic appendectomy were selected as laparoscopic group and another 55 acute appendicitis patients treated with open appendectomy at the same time were selected as laparotomy group.All patients were followed up for three months.The operative effects (operation time, intraoperative blood loss, anal exsufflation time, and hospitalization time) and postoperative complications of the two groups were compared.Results The laparoscopy group showed longer operation time, less intraoperative blood loss, less anal exsufflation time and hospitalization time, and lower incidence rate of complications than the laparotomy group (P<0.05).Conclusion Compared with traditional open appendectomy, laparoscopic appendectomy can obviously improve the surgical effects and reduce the incidence of postoperative complications in the treatment of acute appendicitis. References | Related Articles | Metrics

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Clinical observation of double-mirror combined with cystic duct and common bile duct exploration for extrahepatic bile duct stones YONG Hai, SUN Yongqiang 2019, 8 (2):  115-117.  doi: 10.3969/j.issn.2095-378X.2019.02.011 Abstract ( 153 )   PDF (756KB) ( 395 )   Save Objective To explore the clinical efficacy of double-mirror combined with cystic duct and common bile duct exploration and incision for extrahepatic bile duct stones.Methods Forty patients with extrahepatic bile duct stones from December 1, 2017 to January 30, 2019 were randomly divided into observation group (double-mirror combined with cystic duct and common bile duct exploration) and control group (laparoscopic common bile duct exploration).The clinical efficacy and safety between the two groups were compared.Results The observation group showed lower incidence rate of complications, operation time, intraoperative blood loss, recovery time of gastrointestinal function, and drainage time of abdominal cavity than the control group (P<0.05).The alanine aminotransferase, alkaline phosphatasey, glutamyl transpeptidase, and cholinesterase of the observation group were superior to those of the control group (P<0.05).Conclusion Double-mirror combined with cystic duct and common bile duct exploration is effective and safe for extrahepatic bile duct stones. References | Related Articles | Metrics

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Surgical experience of hepatic cyst connected with bile duct LIU Pengfei, XU Wen, LIU Kai, YE Chun 2019, 8 (2):  118-119.  doi: 10.3969/j.issn.2095-378X.2019.02.012 Abstract ( 183 )   PDF (735KB) ( 567 )   Save One of the difficulties in the surgical treatment of hepatic cyst is cyst connected with bile duct.In this article, we reported our experience in the treatment of 9 patients with this disease such as hepatic cyst and jejunal Roux-en-Y anastomosis, common bile duct drainage, and endoscopic nasobiliary drainage (ENBD), aiming to provide references for clinical work. References | Related Articles | Metrics

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Application of intraoperative ultrasound in intracranial tumor surgery CHENG Xiaoying, YE Feng 2019, 8 (2):  120-123.  doi: 10.3969/j.issn.2095-378X.2019.02.013 Abstract ( 153 )   PDF (1218KB) ( 300 )   Save Objective To explore the effect of intraoperative ultrasound on intracranial tumor surgery.Methods A total of 63 patients with intraoperative ultrasound in intracranial tumor surgery from January 2017 to November 2018 were selected as ultrasound group.During the same period, 33 patients with intracranial tumor surgery but without ultrasound detection were selected as control group.The pathology results, extent of tumor resection, and prognosis were compared between the two groups.Results The pathology Results showed that in the control group, there were 18 cases of glioma, 6 cases of meningeoma, 3 cases of cavernous hemangioma, 3 cases of metastatic tumor, 2 cases of schwannoma, and 1 case of other intracranial tumor; in the ultrasound group, there were 33 cases of glioma, 13 cases of meningeoma, 6 cases of cavernous hemangioma, 5 cases of metastatic tumor, 4 cases of schwannoma, and 2 cases of other intracranial tumor.The total resection rate of tumor in the ultrasound group was obviously higher than that in the control group (P<0.05).The scores of KPS in the two groups after treatment were improved obviously (P<0.05), and the score in the ultrasound group was better than that in the control group (P<0.05).Conclusion Intraoperative ultrasound could detect the tumor in real time and significantly improve the total resection rate of tumor, thus is worthy of clinical promotion. References | Related Articles | Metrics

Education and management on public health

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Investigation and analysis on humanistic quality of clinical medical students with standardized residency training ZHANG Mengmeng, SHI Shengjun, WU Shunqiang, LIN Hui, BI Yanlong, ZHANG Jing, JIN Lingjing, CHENG Liming, ZHOU Qi 2019, 8 (2):  124-129.  doi: 10.3969/j.issn.2095-378X.2019.02.014 Abstract ( 156 )   PDF (768KB) ( 412 )   Save Objective To investigate and analyze the humanistic quality of clinical medical students provided with standardized residency traning.Methods A self-designed questionnaire survey was conducted to collect information on general understanding of humanistic quality and dimentional humanistic quality such as literature and history, medicine, politics, and volunteer service among 53 medical students aged 22-28 (25.21±1.43) years old from 11 standardized residency training bases of Tongji Hospital Affiliated to Tongji University.Results The medical students had a high level of general understanding of humanistic quality (4.0±0.9).Their scores of humanistic literacy in politics (3.596±0.916), medicine (3.217±0.682), and volunteer service (3.373±1.523) were high, while their scores of humanistic literacy in literature and history (2.027±0.743) needed to be improved.Conclusion The overall humanistic quality of the medical students with standardized residency training is relatively high, but there is still room for improvement, so as to cultivate high-level medical professionals. References | Related Articles | Metrics

Medical instrument

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Application and development of mechanical ventilation LI Panyu 2019, 8 (2):  130-134.  doi: 10.3969/j.issn.2095-378X.2019.02.015 Abstract ( 189 )   PDF (1050KB) ( 561 )   Save Mechanical ventilation technology has a history of more than 100 years.With the progress of science and technology and the increasing of clinical demands, mechanical ventilation technology not only meets patients’ ventilation needs, but also integrates more and more advanced ventilation functions.This paper reviewed how ventilators work, introduced the application of new ventilation modes, and analyzed the future development trend of mechanical ventilation. References | Related Articles | Metrics

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Detection for quality control of high-frequency electrotome YAN Wenjie, LANG Tao 2019, 8 (2):  135-137.  doi: 10.3969/j.issn.2095-378X.2019.02.016 Abstract ( 172 )   PDF (749KB) ( 618 )   Save High-frequency electrotome, one of the commonly used medical equipment in hospital operation nowadays, uses high-power and high-frequency current to cut and coagulate human tissues, which has a high risk of clinical use.In recent years, with the improvement of medical level, the clinical application of high-frequency electrotome is also increasingly extensive; therefore, in order to ensure the safety, reliability, and best performance of high-frequency electrotome, regular quality control inspection of high-frequency electrotome and more attention of clinical engineers to quality management are required.This paper discussed the detection method of high frequency electrotome for quality control, so that clinical engineers could manage the equipment more effectively. References | Related Articles | Metrics

Nursing

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Application value of artificial intelligence robot in the follow-up of patients after biliary and pancreatic day surgery WU Lingdi, WANG Wei 2019, 8 (2):  138-140.  doi: 10.3969/j.issn.2095-378X.2019.02.017 Abstract ( 146 )   PDF (741KB) ( 386 )   Save Objective To evaluate the feasibility of artificial intelligence robot in the follow-up of patients after biliary and pancreatic day surgery.Methods A retrospective descriptive study was conducted to collect the follow-up data of 1 073 patients who were admitted to biliary and pancreatic day surgery from July to December 2018.The rates of telephone connection, complete index collection, and patient satisfaction were observed.Results The rates of telephone connection, complete index collection, and patient satisfaction of artificial intelligence robot in 6-month follow-up of patients after biliary and pancreatic surgery were as high as 95.62%, 83.79%, and 96.06%, respectively.Conclusion Artificial intelligence robots play an active role and are feasible in the follow-up of patients undergoing day surgery. References | Related Articles | Metrics

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Application of quality control circle in reducing failure rate of venous blood collection in patients GE Qin, YANG Haojun, YANG Xiangdong, JIN Lichen 2019, 8 (2):  141-144.  doi: 10.3969/j.issn.2095-378X.2019.02.018 Abstract ( 145 )   PDF (964KB) ( 426 )   Save Objective To investigate the effect of quality control circle activities on reducing the failure rate of venous blood collection in patients.Methods We established a quality control circle and carried out an activity themed on "reducing the failure rate of venous blood collection in patients" by PDCA circulation to understand the status quo, set goals, analyze causes, and formulate countermeasures.Results After implementing the quality control circle activity, the failure rate of venous blood collection in patients was effectively reduced from 9.92 % to 2.58 %, reaching the target value of 2.6%.Conclusion The quality control circle activity could improve the quality and reduce the failure rate of venous blood collection. References | Related Articles | Metrics

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Correlation analysis of operating room nursing management with nosocomial infection control levels LI Qun 2019, 8 (2):  145-147.  doi: 10.3969/j.issn.2095-378X.2019.02.019 Abstract ( 143 )   PDF (750KB) ( 493 )   Save Objective To analyze the correlation of operating room nursing management with nosocomial infection levels.Methods A total of 405 patients treated from March 2017 to June 2018 in our operating room were selected.Patients were assigned to infection group (n=204) and non-infection group (n=201) according to the nosocomial infection conditions.The correlation of nosocomial infection control levels with operating room nursing management was analyzed.Results The operation time, consecutive operation, incision types, preoperative application of antibiotics, and invasive surgery between the infection group and the non-infection group were statistically different (P<0.05).According to the logistic regression equation, the influencing factors of nosocomial infection included the operation time, consecutive operation, incision types, preoperative application of antibiotics, and invasive surgery.The nosocomial infection was positively correlated with operation time, consecutive operation, Type Ⅱ incision, preoperative application of antibiotics, and invasive surgery (P<0.05).Conclusion The nosocomial infection control levels have a close correlation with the operating room nursing management.Therefore, the medical staff shall strive to summarize the operation experiences, optimize the nursing mode, and improve the nursing management so as to reduce the incidence rate of nosocomial infection. References | Related Articles | Metrics

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Effect of nursing intervention on limb function recovery after fracture surgery WU Hailing 2019, 8 (2):  148-150.  doi: 10.3969/j.issn.2095-378X.2019.02.020 Abstract ( 120 )   PDF (743KB) ( 518 )   Save Objective To evaluate the effect of nursing intervention on limb function recovery after fracture surgery.Methods A total of 150 patients who received fracture surgery in our hospital from January 2016 to December 2017 were selected as study subjects and randomly divided into observation group and control group, with 75 patients in each group.After surgery, the patients in the control group were given routine care, and the patients in the observation group were additionally given upgraded care.Limb function recovery and complications of the two groups of patients were compared.Results The total effective rate of limb function recovery in the observation group was significantly higher than that in the control group (P<0.05).The incidence rate of complications in the observation group was lower than that in the control group (P<0.05).Conclusion Upgraded nursing care intervention for patients with fracture surgery could obviously improve limb function recovery and reduce the occurrence of complications, and is worthy of popularizing. References | Related Articles | Metrics