Operating room (OR) nurses face elevated risks of work-related musculoskeletal disorders (WMSDs) due to sustained awkward postures, heavy patient handling, and prolonged static loading. However, procedure-level ergonomic risk profiles across the full spectrum of OR nursing tasks remain inadequately characterized. A cross-sectional observational study was conducted among 25 OR nurses in a tertiary hospital in Baoding, China. Twelve common nursing procedures were systematically evaluated using the Swedish Ergonomic Hazard Identification Method (PLIBEL) for qualitative hazard screening and the Rapid Upper Limb Assessment (RULA) for quantitative risk scoring. Joint angles were measured using Kinovea (version 2025.1.0) motion analysis software to ensure objective RULA scoring. Inter-rater reliability was maintained through dual-assessor evaluation and consensus. PLIBEL identified a total of 243 adverse ergonomic factors across the 12 procedures, with individual procedures ranging from 13 to 25 factors. All procedures shared two common exposures: unsupported standing posture and fatiguing leg work. RULA grand scores ranged from 4 to 7, corresponding to risk levels II through IV. Five procedures achieved the maximum score of 7 (Level IV, very high risk): lateral positioning, prone positioning, postoperative patient transfer, stretcher transport, and equipment transport. These high-risk procedures were characterized by severe trunk flexion, asymmetric leg loading, and external loads exceeding 10 kg. Six procedures scored in the medium-risk range (RULA 5–6), while needle threading scored 4 (Level II, low risk). PLIBEL and RULA findings converged to identify patient positioning and transfer tasks as the highest-priority targets for ergonomic intervention. Adverse ergonomic factors are prevalent across common OR nursing procedures, with patient positioning and transfer tasks posing the most prominent risks. The combined application of PLIBEL and RULA offers complementary strengths—PLIBEL enabling comprehensive hazard identification and RULA providing graded risk quantification—generating actionable, procedure-specific risk profiles that identify the highest-priority targets for ergonomic intervention.

To identify and evaluate ergonomic risks among scrub nurses during coronary artery bypass grafting (CABG) using the Swedish Ergonomic Hazard Identification Method (PLIBEL) and the Quick Exposure Check (QEC). This pilot study was designed to test the feasibility of applying PLIBEL and QEC for ergonomic risk assessment in CABG scrub nurses and to generate preliminary risk profiles. Fifteen scrub nurses from a tertiary hospital in Baoding, China, were enrolled, with each nurse observed during three CABG procedures, resulting in a total of 45 observed operations. The CABG procedure was divided into 11 stages. Two trained observers performed on-site PLIBEL identification and QEC scoring. Video recordings were made during high-load stages, and Kinovea software was used as an auxiliary tool to support observer scoring. QEC scores across stages were compared using the Friedman test. A total of 311 adverse ergonomic factors were identified across the 11 stages. The postoperative finishing stage showed the highest risk, with the “surgical instrument cleaning and disposal” step contributing 36 factors. During intraoperative cooperation, thoracotomy, internal mammary artery harvesting, and vessel anastomosis each had 30–31 adverse factors. QEC scores revealed that static back load reached a high level in the vessel anastomosis cooperation and instrument counting stages, while the neck reached a high load in the vessel anastomosis cooperation, chest closure cooperation, and instrument cleaning stages. Friedman test showed significant stage differences for all body regions (back dynamic P = 0.02, others P < 0.001). The E-value ranged from 38.8% to 61.1%; five stages were high-risk (51%–70%), with the highest in vessel anastomosis cooperation (61.1%). In this small-scale, single-center pilot study, the combination of PLIBEL and QEC appears to be a feasible and useful approach for the preliminary identification of ergonomic risks for CABG scrub nurses. The vessel anastomosis cooperation stage had the highest overall risk, and the neck was the most loaded body region. Targeted interventions, including environmental optimization, workflow restructuring, and ergonomics training, are suggested for high-risk stages, although these recommendations require further evaluation in larger, multicenter studies.

The purpose of this study is to investigate the influence of kinesiophobia following Total Knee Arthroplasty (TKA) on the rehabilitation outcomes of patients during hospitalization, includes examining the trends in resting pain levels at various time points post-surgery, the trends in active flexion of the knee at various time points post-surgery, and the effects of kinesiophobia on the timing of first postoperative ambulation, the duration of postoperative hospital stay, and the results of the two-minute walk test on the day of discharge. Postoperative kinesiophobia in patients was identified using the Tampa Scale for Kinesiophobia (TSK), with 33 patients scoring >37 points and 35 patients scoring ≤37 points. Resting Pain levels were assessed using the Numerical Rating Scale (NRS) at various time points, including upon return to the ward (T1), the first (T2), second (T3), third (T4), fifth(T5) postoperative days, and the day of discharge (T6). Furthermore, active flexion of the knee joint was measured at different time points for both groups, including the first (T1*), third (T2*), and fifth (T3*) postoperative days, and the day of discharge (T4*). The first time out of bed activities of the two groups of patients were compared, along with the results of the 2-Minute Walk Test (2-MWT) on the day of discharge. The pain scores of patients in the kinesiophobia group at different time points after surgery were worse than those in the non-kinesiophobia group (P<0.05). There were significant time effects (F = 131.297;P<0.01), inter-group effects (F = 15.016; P<0.01), and interaction effects (F = 5.116; P<0.05). The active knee flexion of patients in the kinesiophobia group at different time points after surgery were worse than those in the non-kinesiophobia group (P<0.05).There were significant time effects (F = 628.258;P<0.01), inter-group effects (F = 16.546; P<0.01), and interaction effects (F = 66.025; P<0.01). Patients in the kinesiophobia group delayed getting out of bed for the first time (35.39±9.82vs28.77±9.81hours; P<0.01), had shorter activity time (4.12±1.36vs5.80±1.96minutes; P<0.01) and distance (19.12±3.36vs30.17±5.64meters;P<0.01), and experienced higher pain scores during activity (6.30±1.10vs5.48±0.95scoresP<0.05). Additionally, patients in the kinesiophobia group walked shorter distances in the 2-MWT test on the day of discharge compared to the non-kinesiophobia group (37.60±5.76vs50.68±5.37meters;P<0.05), and had longer hospitalization time (8.11±1.31vs50.68±5.37days; P<0.05). In short, compared to patients without kinesiophobia, the presence of kinesiophobia after TKA surgery significantly impacts the efficacy of early rehabilitation exercises during hospitalization. This impact is observed in pain perception, knee joint mobility, the 2-minute walk test, etc. Early identification of patients with kinesiophobia after TKA and timely intervention are necessary and beneficial.

Objective:This study aims to investigate the influence of kinesiophobia on the rehabilitation outcomes of patients undergoing knee replacement surgery during their hospital stay. Methods:The study conveniently selected patients who underwent unilateral knee replacement at a tertiary hospital in Baoding City between June 2021 and December 2021.A self-designed questionnaire was utilized to gather data on the patients' general demographic and disease information, while the Tampa Scale for Kinesiophobia (TSK) was employed to identify postoperative kinesiophobia. Out of the total sample, 33 patients scored above 37 points on the TSK, while 35 patients scored 37 points or below.The Numerical Rating Scale (NRS) was utilized to assess pain levels in two groups of patients at various time points post-surgery: upon returning to the ward after surgery (T1), the first day after surgery (T2), the second day after surgery (T3), the third day after surgery (T4), resting pain in the knee joint on the fifth postoperative day (T5), and on the day of discharge (T6). The flexion of the knee joint was measured in two groups of patients on the first postoperative day (T1*), the third postoperative day (T2*), the fifth postoperative day (T3*), and the day of discharge (T4*).The first time out of bed activities of the two groups of patients were compared, along with the results of the 2-Minute Walk Test (2-MWT) on the day of discharge and the postoperative hospital stay. Results:The pain scores of patients in the kinesiophobia group were consistently higher than those in the non-kinesiphobia group at all time points (P<0.05). There were observed time effect, Between-group effects, and interaction effects (P<0.05). Additionally, the active knee flexion of patients in the kinesiphobia group was found to be smaller compared to the non-kinesiophobia group at each time point (P<0.05), There were observed time effect, Between-group effects, and interaction effects (P<0.05). Patients in the kinesiophobia group also exhibited delayed time to first get out of bed, shorter activity time and distance, as well as higher pain scores during activities, in comparison to those in the non-kinesiophobia group (P<0.05). Furthermore, patients with kinesiophobia walked shorter distances in the 2-minute walk test on the day of discharge and had longer hospitalization times than their non-kinesiophobia counterparts (P<0.05). Conclusion:Kinesiophobia following knee replacement surgery has a significant impact on the rehabilitation outcomes of patients while they are hospitalized. It is important for healthcare professionals to promptly recognize and address this issue in order to enhance the rehabilitation progress of these patients during their hospital stay.

This study aimed to investigate the minimum number of operations required for itinerant nurses in the operating room to master the skills needed to operate the Ti-robot-assisted spinal surgery equipment. Additionally, we aimed to provide a corresponding basis for the development of qualification admission criteria and skill training for nurses who cooperate with this type of surgery. Nine operating room itinerant nurses independently performed Ti-robot equipment simulations using a spine model as a tool, with 16 operations per trainee. Four evaluation indices were recorded: time spent on equipment preparation and line connections, time spent on image acquisition and transmission, time spent on surgical spine screw placement planning, and time spent on robot arm operation. Individual and general learning curves were plotted using cumulative sum analysis. The number of cases in which the slope of the individual learning curves began to decrease was 3-11 cases, and the number of cases in which the slope of the general learning curve began to decrease was 8 cases. The numbers of cases in which the learning curves began to decrease in the four phases were the 5th, 8th, 11th, and 3rd cases. Itinerant nurses required at least eight cases to master the equipment operation skills of Ti-robot-assisted spinal surgery. Among the four phases, the image acquisition and transmission phases and the surgical spine screw placement planning phase were the most difficult and must be emphasized in future training.

Recent studies have reported a prevalence of sleep disturbance in patients undergoing arthroscopic rotator cuff repair. The purpose of our study was to explore patient-reported factors correlated with sleep disturbance in patients with arthroscopic rotator cuff repair. We retrospectively evaluated 133 patients who underwent arthroscopic rotator cuff repair for 6 months. We obtained the Pittsburgh Sleep Quality Index (PSQI) scores, the visual analog scale (VAS) pain score, the University of California-Los Angeles Shoulder Rating Scale score (UCLA score), the Hospital Anxiety and Depression Scale (HADS), and patient demographics. According to the PSQI scores, participants were divided into a sleep disorder group (A group, PSQI >= 5) and a normal sleep group (B group, PSQI <5). Statistical analyses included Student t test, Mann-Whitney U test, chi-square test, and binary logistic regression analysis to determine which patient-reported factors were associated with sleep disturbance. The mean VAS, UCLA score, UCLA Flexion, HADS-Anxiety (HADS-A), and HADS-Depression (HADS-D) scores in group A were 3.54, 26.36, 3.25, 5.43, and 5.93, respectively; in group B, the mean scores were 1.49, 30.72, 4.50, 2.11, and 1.79, respectively. There were statistically significant differences in the VAS, UCLA, UCLA Flexion, HADS-A, HADS-D scores between the 2 groups (P < .05). In the categories of sex, age, body mass index, and tear size, there was no statistical significant difference between the 2 groups. (P > .05). HADS-D and UCLA Flexion were independent factors affecting sleep disturbance after arthroscopic rotator cuff repair at 6 months (P < .05). Our study demonstrated that patients with sleep disturbances after arthroscopic shoulder surgery had a close relationship with the HADS-D, UCLA Flexion scores and had more pain, more dysfunction, and more pronounced psychological abnormalities. Therefore, more emphasis on psychotherapy and rehabilitation is required for patients with sleep disturbance.

Objective:To explore the occurrence of phobia in knee replacement patients and its effect on rehabilitation exercise compliance and rehabilitation effect.Methods:A total of 372 patients with knee osteoarthritis who received total knee arthroplasty(TKA) at the First Central Hospital of Baoding from December 2020 to December 2021 and met the inclusion and exclusion criteria were selected for postoperative evaluation using the Tampa scale of kinesiophobia (TSK) for fear of movement. Inclusion criteria: the patients meet the diagnosis of knee osteoarthritis, primary TKA, age is from 50 to 75 years. Exclusion criteria: osteoarthritis of other joints, mental disorders, combining neuropathy or other skeletal muscular diseases, severe dysfunction of organs, prosthesis loosening, infection or bone fractures after surgery. They were divided into a fear group (TSK >37 points) and a non fear group (TSK ≤ 37 points). The general information and rehabilitation effectiveness indicators of the two groups were compared by chi square test and t test, including visual analogue scale (VAS), American Knee Association rating scale (AKSS), knee range of motion (ROM), Berg balance scale, and social support rating scale (SSRS). The correlation between the occurrence of anxiety disorder and rehabilitation outcomes as well as social support were analyzed.Results:Among the 372 patients undergoing TKA surgery, 108 patients developed fear of movement, while 264 patients did not. The incidence of fear of movement was 29.03%. The average score of the TSK scale in the panic group (42±3) was higher than that in the non panic group (21±6)( t=36.061, P<0.001). VAS score of the motor phobia group was higher than that of the non motor phobia group, while the AKSS, ROM, Berg balance scale and SRSS scores were lower than those of the non motor phobia group, with statistically significant differences (t=41.772, -21.384, -34.295, -22.906, -26.374, all P<0.05). TSK score was positively correlated with VAS score (r=0.860, P<0.001), negatively correlated with AKSS, ROM, Berg balance scale and SRSS scores (r =-0.499, -0.664, -0.529, -0.574, all P <0.001), negatively correlated with VAS score (r =-0.639, P <0.001), and positively correlated with AKSS, ROM, Berg balance scale score (r =0.842, 0.864, 0.849, all P<0.001). The results of binary logistic regression analysis showed that age[odds ratio(OR) =1.695, 95%confidence interval(CI)(1.513, 1.899)], gender[OR=0.257, 95%CI(0.149, 0.441)], body mass index[OR=6.342, 95%CI(4.308, 9.335)], years of pain[OR=5.390, 95%CI(3.597, 8.075)], VAS[OR=2.510, 95%CI(1.872, 3.366)], Berg balance scale[OR=0.477, 95%CI(0.391, 0.581)] and SRSS scores[OR=0.594, 95%CI(0.523, 0.675)] were independent influencing factors on the occurrence of motor phobia(all P<0.05).Conclusions:Knee arthroplasty has a higher incidence of phobia, and its rehabilitation effect and social support are worse than those of non phobia patients. The occurrence of ADHD is closely related to rehabilitation effect and social support, and there is a positive correlation between rehabilitation effect and social support. The intervention of postoperative rehabilitation effect and social support of patients undergoing knee arthroplasty should be enhanced.

Abstract Background : Recent studies have found a prevalence of sleep disturbance in patients with arthroscopic rotator cuff repair. The purpose of our study was to determine which patient-reported factors correlate with sleep disturbance in patients with arthroscopic rotator cuff repair. Methods : We prospectively evaluated 133 patients who had had arthroscopic rotator cuff repaired for 6 months. We obtained the Pittsburgh Sleep Quality Index (PSQI) scores, the visual analog scale (VAS) pain score, the University of California-Los Angeles Shoulder Rating Scale score (UCLA score), the Hospital Anxiety and Depression Scale (HADS), and patient demographic. According to PSQI scores, participants were divided into a sleep disorder group ( A group, PSQI ≥ 5 ) and a normal sleep group (B group, PSQI < 5). Statistical analysis included the Student t-tests, Mann-Whitney U-test，chi-square tests, and binary logistic regression analysis to determine which patient-reported factors were associated with sleep disturbance. Results : The mean scores on the VAS, UCLA Score, UCLA Flexion, HADS-Anxiety (HADS-A), and HADS-Depression(HADS-D) in group A were 3.54, 26.36, 3.25, 5.43, and 5.93, respectively; while in group B were 1.49, 30.72, 4.50, 2.11, and 1.79, respectively. There was a statistically significant difference for scores on the VAS, UCLA, UCLA Flexion, HADS-A, HADS-D between the 2 groups (P < 0.05). In the categories of gender, age, BMI, and tear size, there was no statistically significant difference between the two groups. (P > 0.05). HADS-D and UCLA Flexion were independent factors affecting sleep disturbance after arthroscopic rotator cuff repair 6 months (P < 0.05). Conclusions : Our study demonstrated patients with sleep disturbances after arthroscopic shoulder surgery had severe pain, more obvious dysfunction, and more pronounced psychologic abnormalities, and the close relationships of depression, UCLA Flexion scores, and sleep disturbance may indicate that more emphasis on psychotherapy and rehabilitation is required.

目的 探讨术后恐动症对膝关节置换患者住院期间康复效果的影响.方法 选取2020年6—12月医院行单侧膝关节置换术的患者68例.收集患者一般人口学资料与疾病资料,运用恐动症评分表(TSK)识别术后恐动症患者,其中TSK评分>37分33例作为恐动症组,TSK评分≤37分35例作为非恐动症组.采用疼痛数字评分表(NRS)评估两组患者术后返回病房时(T1)、术后第1天(T2)、术后第2天(T3)、术后第3天(T4)、术后第5天(T5)、出院当天(T6)膝关节静息痛.测量两组患者术后第1天(T1)、术后第3天(T2)、术后第5天(T3)、出院当天(T4)膝关节主动屈曲度.比较两组患者首次下床活动情况、出院当天2 min步行测试(2-MWT)结果与术后住院时间.结果 两组患者疼痛评分均呈逐渐下降的趋势,膝关节主动屈曲度均呈逐渐上升的趋势,时间之间差异有统计学意义(P时间<0.05);各个时间点恐动症组患者疼痛评分高于非恐动症组,膝关节主动屈曲度低于非恐动症组,差异有统计学意义(P组间<0.05);随观察时间延长,组间差异逐渐增大,组间随时间变化的差异有统计学意义(P交互<0.05).恐动症组患者首次下床时间晚于非恐动症组,活动时间短于非恐动症组,活动距离短于非恐动症组,活动时疼痛评分高于非恐动症组(P<0.05),在出院当天2 min步行测试中行走距离短于非恐动症组,术后住院时间长于非恐动症组(P<0.05).结论 术后恐动症影响膝关节置换患者住院期康复效果,相关人员应早期识别、早期干预恐动症患者,提高其住院期间康复效果.

目的 探究3D胸腔镜肺叶切除术治疗原发性肺癌的临床疗效.方法 2018年10月～2020年2月我院收治的原发性肺癌病人120例.根据手术方式不同分为观察组(67例)和对照组(53例),观察组行3D胸腔镜肺叶切除术,对照组行2D胸腔镜肺叶切除术.观察两组手术情况、淋巴结清扫数目和术后外科病理分期、肺功能指标、疼痛情况和并发症情况.结果 观察组手术时间、术后引流管留置时间、术后住院时间均短于对照组,术中出血量、术后24小时引流量低于对照组,差异有统计学意义(P<0.05).两组淋巴结清扫数目和术后外科病理分期比较,差异无统计学意义(P>0.05).观察组术后3个月用力呼气肺活量1秒量(FEV1)优于对照组,术后3个月视觉模拟疼痛评分(VAS)小于对照组,差异有统计学意义(P<0.05).观察组并发症发生率(5.97％)低于对照组(18.87％),差异有统计学意义(P<0.05).结论 3D胸腔镜肺叶切除术治疗原发性肺癌可缩短手术时间、术后引流管留置时间和术后住院时间,减少术中出血量、术后24小时引流量,改善肺功能,减少疼痛,且并发症发生率较低.

目的:比较利多卡因乳膏与丁卡因胶浆应用于男性病人留置尿管的效果.方法:在全麻诱导前30min,全麻诱导后对各组病人分别用石蜡油,利多卡因乳膏与丁卡因胶浆进行尿道浸润和尿管润滑,行留置尿管操作.运用通过WHO疼痛分级标准制定的尿管耐受性评价方法对各组在尿管置入后1min,全麻苏醒后15min,全麻苏醒后6hour进行尿管耐受性评价.结果:在麻醉诱导前行导尿操作的三组患者,在置管后1 min评分上有统计学差异,P＜0.05,与麻醉诱导后行留置尿管的三组患者分别比较,在麻醉苏醒后15min评分上有统计学差异,P＜0.05.在麻醉诱导后行留置尿管的三组患者中,丁卡因组与其它两纽相比有统计学差异,P＜ 0.05.结论:无论是否应用麻醉浸润剂,全麻诱导前30min行导尿操作对于预防全麻苏醒后患者尿路不适效果明显.利多卡因乳膏与丁卡因胶浆均可显著改善清醒状态下对患者行导尿操作造成的不适感,利多卡因乳膏起效时间较丁卡因胶浆快,而丁卡因胶浆较利多卡因乳膏对尿道的麻醉持续时间更长.预计手术时间≥3hour时推荐使用丁卡因胶浆行留置尿管操作,使用丁卡因胶浆时需适当延长等待起效时间.

针对海战虚拟环境中对舰艇尾浪模拟的需要,提出了一种基于单视点视频对舰艇尾浪进行三维重建的方法.对视频图像进行高斯滤波等预处理,并从视频图像中提取尾浪区域,基于Shape From Shading(SFS)方法计算舰艇尾浪的高度场,生成尾浪网格模型,基于Compute Unified Device Architecture(CUDA)技术计算网格顶点的法线,重建出舰艇尾浪的三维模型.实验结果表明:重建的尾浪具有较高的真实感,提高了尾浪的重建速度,在细节与实时性之间取得了较好的平衡,能够满足实际应用需要.

针对超大型火箭集装箱协同吊装的实际需求,研究和实现了一种基于虚拟现实技术的协同吊装模拟训练系统,首先阐述了系统的总体架构;然后基于开源物理引擎ODE (Open Dynamic Engine),提出了一种基于多刚体动力学模型的钢丝绳模拟方法;在深入分析协同吊装作业过程和特点的基础上,研究和建立了一种协同吊装动力学模型;针对协同吊装过程中各仿真计算机的视景同步显示问题,提出了一种有效的视景同步显示方法.实验结果表明,该系统可以逼真的模拟船载起重机对超大型火箭集装箱进行协同吊装作业的全过程,能够满足日常吊装训练需求,节省训练成本,提升训练效果.