Objective To investigate the opinions of operating room nurse (ORN) on enhanced recovery after surgery (ERAS). Methods A questionnaire survey was performed among 215 ORNs in West China Hospital. There were 10 males and 205 females at age of 33.4±8.84 years. Results A total of 154 ORNs (71.6%) thought that we already had very good ERAS theory but we still needed more practice. Thirty-four ORNs(15.8%) thought that the application of ERAS was poor in our clinic comparing to other countries.A percentage of 84.2% (181/215) ORNs thought the criteria to judge whether the ERAS succeed or not should be average days of hospitalization, patients' feeling, and experience and social satisfactions. Besides, 78.1% (168/215) ORNs selected team building as the key point of ERAS success. There were 91.2% (196/215) ORNs who believed expert consensus and ERAS guide should be worked out and propagandized through academic forum or conference in order to popularize the ERAS. Conclusion The theory of ERAS has already been accepted by almost all the clinicians and team building is the best way to make ERAS work well.
Objective Epidermal stem cells (ESCs) can actively partici pate in wound heal ing and enhance reepithel ial ization. To establ ish ideal diabetes mell itus (DM) rat models and to investigate the expression of keratin 19 (K19),β1-integrin, β-catenin, and prol iferating cell nuclear antigen (PCNA) in ESCs of DM rat model, then to study the potential mechanism of difficult recovering wounds of diabetic skin. Methods Twenty male SD rats (weighing 250-300 g) were dividedinto DM group and normal control group randomly (n=10). The DM rat model was made by intraperitoneal injected 65 mg/kg streptozocin (STZ), the normal control group was not treated. At 4 weeks after injection, pancreatic tissue was harvested for HE staining in two groups. The ESCs isolated from full-thickness skins of the back of two group rats were culutured and identified. The 2nd passage of ESCs were obtained for immunocytochemical staining of K19, β1-integrin, β-catenin, and PCNA. Meanwhile, the cell cycle were measured by flow cytometry. The cell colony formation rates were detected after 1 week. Results The achievement ratio of DM rat model was 90% with good stabil ity. HE staining showed that the number of islet cells significantly decreased with degeneration and necrosis in DM group; the structure of islet cell was clear without degeneration and necrosis in normal control group. The integral absorbance values of positive expression for K19, β1-integrin, β-catenin, and PCNA in ESCs of DM group (82.63 ± 14.77, 21.59 ± 4.71, 6.49 ± 6.58, and 90.77 ± 12.44, respectively) were significantly lower than those in the normal control group (151.24 ± 42.83, 54.48 ± 17.43, 116.39 ± 9.26, and 110.62 ± 20.67, respectively) (P lt; 0.01). The clone forming efficiency of ESCs in DM group (6.43% ± 1.01% ) was significantly lower than that in the normal control group (11.37% ± 1.62%) (P lt; 0.01). Flow cytometry indicated that 88.89% of cultured ESCs in the DM group were in resting state/ pre-DNA-synthetic gap (G0/G1), and the apoptosis rate was 3.98%; 91.50% in the normal control group and the apoptosis rate was 0. Conclusion The DM rat model can be effectively induced by intraperitoneal injected 65 mg/ kg STZ. The decreased amount and the low prol iferation and differentiation capacity of ESCs may be one of the important mechanisms of difficult recovering wounds of DM rats.
Objective To evaluate the advantages about video-assisted thoracoscopic surgery (VATS) lobectomy with optimized management of surgical instruments package. Methods A total of 200 patients with lung cancer were enrolled, which included 78 males and 122 females, aged 24-83 years at median age of 56.8 years. All of them were divided into 2 groups including a routine group (n=100) and an optimized management of surgical instruments group (n=100). The total operation time, bleeding, instrument weights, utilization rate of instruments, counted and cleaning time in 2 groups were recorded and analyzed. Results The average operation time and average lost blood of the routine group was 117.62±42.52 min and 53.14±50.69 ml, respectively, and the one of the optimized instruments group was 120.48±40.62 min, 56.10±49.87 ml, respectively, with no significant difference between the two groups (P=0.112, P=0.231, respectively). The utilization rate of instruments in the routine group (58.02%±2.39%) was significantly lower than that of the optimized instruments group (94.00%±1.48%, P=0.014). The counted time, the loading and unloading time and the cleaning time of instruments in the routine group was 112.00±26.00 s, 70.00±15.00 s, 1 010.00±130.00 s, respectively, much longer than the time of the optimized instruments group, which was 65.00±23.00 s, 20.00±4.00 s, 665.00±69.00 s, respectively. There was a statistical difference between the two groups (P=0.028, P=0.011, P=0.039, respectively). The value of instruments in the routine group (177 574.00±14 438.00 yuan) was apparently higher than that of the optimized instruments group(132 027.00±10 311.00 yuan), with a statistical difference (P=0.032). Conclusion It is demonstrated that optimized management of surgical instruments package in VATS lobectomy can greatly improve the utilization rate of instruments and work efficiency, with no effects on the operation time and amount of bleeding in lobectomy.