To find out whether warm bladder irrigation fluid can decrease the occurrence of perioperative hypothermia, blood loss and shiver in patients treated with benign prostatic hyperplasia (BPH). A comprehensive literature review and meta-analysis that included randomized controlled trials (RCTs) related to temperature of irrigation fluid in the perioperative treatment for BPH was taken by researchers. The relevant literature were searched in Chinese database, such as Retrieval Chinese Journal Full-text Database, VIP Journal Database, Wanfang database, as well as in English search engine and database, including Embase, Cochrane and Medline till January 2018. The study quality was assessed by recommended standards from Cochrane Handbook (version 5.1.0). A total of 28 RCTs and 3858 patients were included. The results showed that the incidences of shiver (risk ratio [RR] = 0.32, 95% confidence interval [CI]: 0.28-0.36, p < 0.001, I 2 = 0%) and hypothermia (RR = 0.36, 95% CI: 0.21-0.59, p < 0.001, I 2 = 67%) in the group of warm irrigation fluid were lower than the group having room-temperature fluid. Room-temperature irrigation fluid group caused a greater drop in body temperature compared to warm irrigation fluid group (p < 0.001, I 2 = 96%). We performed a narrative descriptive statistics only because of substantial heterogeneity. Warm bladder irrigation fluid can decrease the drop of body temperature and the incidence of hypothermia and shiver during and after the operation for BPH. Warm irrigation fluid should be considered as a standard practice in BPH surgeries.

Objective: To investigate the application of virtual reality training in vesicourethral anastomosis during robot-assisted radical prostatectomy (RARP). Methods: Three certified robotic urologists who underwent virtual reality training were enrolled in the study group. The other three without training were enrolled in the control group. Parameters were recorded before and after the training. Then a total of 18 patients un-dergoing RARP were enrolled and randomized assigned to receive anastomosis procedures with certified urologists who either obtained or did not obtain training. The quality of the anastomosis was evaluated. Results: For the virtual training evaluation, the overall score was significantly improved from 65.0 +/- 10.8 to 92.7 +/- 3.5 (p=0.014); the time of anastomosis was shortened; the economy of motion improved; instrument collisions decreased after training (p<0.05). Besides, the effec-tiveness of the virtual training was evaluated in the 18 real anastomosis procedures which were completed either by three urologists with training or three urologists without training. Most intriguingly, the average time of anastomosis was shortened from 40.0 +/- 12.4 min to 25.1 +/- 7.1 min (p=0.015). The parameters including time of operation, creatinine level of drainage, postoperative hospital stay and duration of catheter drainage were comparable before and after training. Two leakages, which were observed in procedures by doctors without training, needed salvage sutures by a senior doctor. Conclusions: Virtual reality training enabled surgeons to become quickly familiar with robotic system manipulation, improved their skills for vesicourethral anastomosis and shortened the learning curve, thus helping them operate with high efficacy and quality. (C) 2021 Editorial Office of Asian Journal of Urology. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).

Hyperglycemia is an independent risk factor for perioperative complications and mortality after cardiac surgery. Freestyle Libre Continuous glucose monitor (CGM) is an interstitial glucose monitoring system, which has been proven to be stable and accurate in various disease. 86 patients with hyperglycemia after cardiac surgery between October 2021 and October 2022 in the cardiovascular ICU, were enrolled in this study. We evaluated systematic errors and numerical accuracy in blood glucose (BG) between two groups using Bland-Altman analysis and mean absolute relative difference (MARD). The clinical accuracy was assessed by consensus and Clarke error grid. 435 paired sensor–reference values were enrolled between the Freestyle and venous BG. The MARD was 18.2% with the Bland-Altman standard bias of 31.87 mg/dL. 1851 paired values were enrolled between the Freestyle and arterial BG. The MARD was 21.5%, and the Bland-Altman standard bias was 41.45 mg/dL. 432 paired values were enrolled between the arterial and venous BG. The MARD was 8.4%, and the Bland-Altman standard bias was − 9.95 mg/dL. Our study demonstrated the relatively low accuracy of Freestyle Libre CGM for critical patients after cardiac surgery. The arterial blood gas glucose analysis acts as an effective tool to improve BG management.

Aim. To investigate the current status of NBDs core competencies through latent profile analysis, identify potential subgroups and their population characteristics, and analyze the influencing factors of different categories. Background. NBDs are essential in the treatment and rehabilitation of burn patients. However, the core competencies of Chinese NBDs are seldom reported. Methods. Our analyses were based on a cross-sectional and multicenter study of 267 Chinese NBDs. Latent profile analysis was employed to identify NBDs core competence profiles using the NBD Core Competencies Self-rating Scale (NBD-CCSS). We then explored the characteristics among different profiles and determined socio-demographic variables associated with profile membership by conducting ANOVA, Chi-square test, and multinominal logistic regression analyses. Results. A 3-profile model provided the best fit. The three profiles were titled skillful competencies (Class 1, n=77, 28.8), moderate competencies (Class 2, n=140, 52.4), and poor competencies (Class 3, n=50, 18.7). Regression analysis suggested that professional title, years of employment, and BICU experience were influencing factors of NBDs profile membership of core competencies. NBDs who were supervisor nurses or above (OR=0.802, 95 CI: 0.009, 0.759), with more than 7years of employment (OR=0.091, 95 CI: 0.009, 0.906) and BICU experience (OR=3.564, 95 CI: 1.423, 8.925) were more likely to fall into Class 1. Conclusions. Our findings could provide evidence for nursing administrators to develop training programs to enhance NBDs core competencies. In particular, variables associated with profile membership determined in the study may facilitate more tailored training strategies.