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Nasojejunal tubes (NJTs) are increasingly used in critically ill patients. NJT insertion with endoscopic- or x-ray-guidance can be achieved with success rates above 90%. This systematic review and meta-analysis of randomized controlled trials (RCTs) compares the efficiency and safety of these two methods in critically ill patients. We searched Chinese and English databases for RCTs comparing endoscopy- and x-ray-guided NJT placement published up to July 5, 2021. Meta-analyses were performed using RevMan5 software to compute mean differences (MDs) and odds ratios (ORs). Eleven RCTs (n=676) were included. The endoscopic group had a higher procedure success rate (OR=2.14, 95% CI [1.19, 3.85], Z=2.52, P=0.01) and shorter insertion time (MD=-3.70 min, 95% CI [-6.90, -0.50], Z=2.27, P=0.02) than the x-ray group. NJT indwelling time and post-insertion complications were similar between groups. The x-ray group had fewer complications during placement (OR=8.08, 95% CI [3.58, 18.22], Z=5.03, P

BACKGROUND: The global neo-coronary pneumonia epidemic has increased the workload of healthcare institutions in various countries and directly affected the physical and psychological recovery of the vast majority of patients requiring hospitalization in China. We anticipate that post-total knee arthroplasty kinesiophobia may have an impact on patients' postoperative pain scores, knee function, and ability to care for themselves in daily life. The purpose of this study is to conduct a micro-video intervention via WeChat to verify the impact of this method on the rapid recovery of patients with kinesiophobia after total knee arthroplasty during neo-coronary pneumonia. METHODS: Using convenience sampling method, 78 patients with kinesiophobia after artificial total knee arthroplasty who met the exclusion criteria were selected and randomly grouped, with the control group receiving routine off-line instruction and the intervention group receiving micro-video intervention, and the changes in the relevant indexes of the two groups of patients at different time points on postoperative day 1, 3 and 7 were recorded and analyzed. RESULTS: There were no statistical differences in the scores of kinesiophobia, pain, knee flexion mobility (ROM) and ability to take care of daily life between the two groups on the first postoperative day (P > .05). On postoperative day 3 and 7, there were statistical differences in Tampa Scale for kinesiophobia, pain, activities of daily living scale score and ROM between the two groups (P 

Our objective was to evaluate the significance of pre-hospital and post-operative serum potassium level monitoring and hypokalemia intervention in laparotomy patients with hypokalemia.A total of 118 laparotomy patients with hypokalemia were randomly divided into an intervention group (N = 60) and a control group (N = 58). Blood samples were collected for measurement of potassium levels at various time points (pre-admission, admission, 24 h and 48 h post-operation) for both groups. Hypokalemia interventions were administered to patients in the intervention group in the pre-admission period and the post-operative period. Visceral dynamics were assessed after laparotomy in both groups.Average serum potassium levels at admission, time period of drinking, and time of first bowel sound after laparotomy differed significantly (p0.001) between the two groups. Average serum potassium levels, first time of defecation, urination, and ambulation at 24 h and 48 h post-operation differed significantly (p0.05) between the two groups.An optimal pathway of serum potassium monitoring not only saves limited ward space but also allows for early correction of hypokalemia in patients undergoing laparotomy.

Background: Blood potassium levels were very important during perioperative management of patients undergoing abdominal surgery. According to various worldwide studies on the causes of hypokalemia and fast-track surgeries, prehospital hypokalemia was ignored. Objective: The aim of this study to construct a prevention and control system of hypokalemia through proper clinical pathways and investigate the effects in terms of fast postoperative recovery of patients undergoing open abdominal surgery. Methods: A total of 104 patients were randomized to an observation group or a control group. The prevention and control system of hypokalemia was constructed; it was composed of 3 major modules: blood potassium monitoring, etiologic intervention, and treatment of hypokalemia. In the observation group, blood was sampled at scheduled time points (the blood potassium monitoring module) and interventions involved the preadmission and pre- and postoperative periods (etiologic intervention module). In the control group, blood sampling was delayed until after admission (blood potassium monitoring module) and interventions were only performed during the pre- and postoperative periods (etiologic intervention module). In terms of blood potassium, indices regarding gastrointestinal motility and postoperative complications were compared. Results: The severity of hypokalemia, postoperative defecation time, arrhythmia, fatigue syndrome, and urine retention differed statistically between the 2 groups (P o 0.05). The times to detect hypokalemia and resolve the blood condition before and after the surgery and at the first bowel sound, defecation and evacuation times differed significantly between the 2 groups (P o 0.01). Conclusions: The prevention and control system of hypokalemia with the starting point being before admission was more effective and allows early prevention, detection, correction, surgery, and recovery of patients undergoing open abdominal surgeries and also could be used in other specialized nursing fields.

Fluid resuscitation was used on aged patients with traumatic shock in their early postoperative recovery. The present study aimed to assess whether different fluid resuscitation strategies had an influence on aged patients with traumatic shock. A total of 219 patients with traumatic shock were recruited retrospectively. Lactated Ringer and hydroxyethyl starch solution were transfused for fluid resuscitation before definite hemorrhagic surgery. Subjects were divided into 3 groups: group A: 72 patients were given aggressive fluid infusion at 20 to 30 mL/min to restore normal mean arterial pressure (MAP) of 65 to 75 mm Hg. Group B: 72 patients were slowly given restrictive hypotensive fluid infusion at 4 to 5 mL/min to maintain MAP of 50 to 65 mm Hg. Group C: 75 patients were given personalized infusion to achieve MAP of 75 to 85 mm Hg. Preoperative infusion volume, preoperative MAP, optimal initial points for surgery, postoperative shock time and mortality rates at 6 and 24 hours after surgery were determined. No significant difference in clinical characteristics was found among the 3 groups. Amount of preoperative infusion was considerably lower in the restrictive group (P