Based on the clinical application of ERA (easy resilient attachment), the construction of two kinds of ERA were introduced including outside-crown-EAR and root-EAR. The clinical operation and attention of EAR application were demonstrated by clinical cases.

Objective To investigate the variation in the position of conus medullaris in Chinese adult population in order to avoid hitting conus during spinal puncture. Methods Eight hundred patients suffering from back pain, aged 18-91 yr, were enrolled in this study. The position of conus medullaris was determined using Siemens 1.5 T magnetic resonance imaging system. According to the method described by Reimann, the vertebral body was used as mark of reference to the level of the end of conus. Results There were 190 patients in whom the position of the end of conus medullaris was lower than L1,2 . The incidence of the position of the end of conus medullaris lower than L1,2 was higher in patients 30-60 or older than in those under 30, and in those over the age of 60 than in those 30-60 (P ＜ 0.05). Conclusion Spinal puncture should be performed cautiously at L2,3. CT or MRI is recommended before operation for the patients to locate the position of conus medullaris and avoid injury to the spinal cord.

Objective To compare the performances of Monaco and Pinnacle treatment planning systems (TPS) for volumetric modulated arc therapy (VMAT) optimization regarding lung cancer.The TPS was compared in terms of dose distributions,treatment delivery parameters and quality control results.Methods For 20 patients,including 10 cases of left lung cancer and l0 cases of right lung cancer,two VMAT plans were generated for each case:one with Monaco 3.0 TPS and the other with Pinnacle 9.2 TPS.Two plans were compared among plan dosimetrie distribution.conformity index and homogeneity index of the targets,the average dose,maximum dose,minimum dose and interested dose volume histograms of organs at risk(OAR,and delivery time and MUs of the therapy plans,the accuracy of treatment plans dose verification.Results Monaco provided better PTV coverage than Pinnacle (t =5.927-12.034,P ＜ 0.05) except Dminof PTV.Monaco had a worse sparing effect on lung than Pinnacle (t =3.545-7.485,P ＜0.05) except V10of diseased side lung and V5of total lung.In addition,Monaco had a better sparing effect on heart(t =2.836-4.011,P ＜0.05).Monaco had fewer delivery time(t =9.780,P ＜0.05)and MUs(t =5.304,P ＜0.05)of the therapy plans,and the pass rate of QA was better than Pinnacle(t =4.937,P ＜ 0.05).Conclusions For lung cancer patients,VMAT treatment plans obtained with Monaco and Pinnacle could offer clinically acceptable dose distributions.Pinnacle might have a better sparing effect on lung and fewer delivery time and MUs of the therapy plans.Monaco had a better PTV coverage and heart sparing.Moreover,Monaco had better accuracy of treatment plans dose verification.

Objective To optimize the formulation of the sunscreen used in military training.Methods The different formulations of sunscreen were prepared according to the orthogonal design,and then applied on 3M adhesive tape posted on the color dish with a certain amount;the absorbance in 280 nm-320 nm and 320 nm-400 nm of them were measured and the arithmetic mean (A) was concluded.By comparing A,the protective effect and the main factors affecting preventive bask were determined.The preventive bask test of the optimum formula was carried out in human trials using the method of multi point increasing ultraviolet irradiation.Results OMC,TinosorbTM M,rutin,pearl powder and baicalin all had significant effects in preventing UVA.OMC had a significant effect in preventing UVB.The formula 1 (containing the five materials mentioned above) had the best effects in preventing both UVA (SPF 18) and UVB (PA+).Conclusions The formula 1 has the best effects in preventing both UVA and UVB.

Objective To study the rat pulmonary irritant of aerosol inhaled Tanreqing and Reduning injection .Methods Rats were devided into two groups for each medicine (low concentration group and high concentration group ) ,nebulized drug administration for seven days ,with the control group irrigated with saline ,and were sacrificed .Through bronchoalveolar lav-age ,excurrent bronchoalveolar lavage fluid (BALF) was used for total protein determination and LDH vitality test to evaluate pulmonary toxicity of two medicines .Results The protein concentrations of two groups in low and high concentrations of Tan-reqing and Reduning respectively are (193 .78 ± 27 .74) ,(235.33 ± 50.41)μg/ml;(174 .02 ± 17 .82) ,(227 .27 ± 66 .03)μg/ml;LDH vitalities respectively are 1065 .21 ± 181 .76 ,1467 .33 ± 101 .87;307 .97 ± 47 .56 ,1377 .29 ± 566 .48 .By t-test ,compared with normal saline ,there was no significant effect among these five groups on protein concentration ,but these two medicine were able to improve LDH activity (P<0 .05) which was more obvious in high concentration group .When two medicines were in low concentration ,LDH activity was higher in Tanreqing group with statistical significance (P<0 .05) .Conclusion Aero-sol inhaled Tanreqing and Reduning injection in rats have some pulmonary irritation and potential safety hazard in this delivery w ay .

Attitude to Health ; Female ; Health Policy ; Humans ; Informed Consent ; ethics ; legislation & jurisprudence ; psychology ; Male ; Singapore ; Students ; psychology ; Tissue and Organ Procurement ; ethics ; legislation & jurisprudence ; Universities ; Young Adult

Objective To evaluate the effects of disposable medical sponge toothbrush combined with oral irrigation in oral nursing among oral tracheal intubation patients. Methods From August 2017 to August 2018, we selected 71 cerebral infarction patients with oral tracheal intubation of Neurology Intensive Care Unit at Affiliated Hospital of Nantong University by convenience sampling. All of the patients were divided into observation group (n=36) and control group (n=35) with the random number table. Observation group carried out the oral nursing by medical sponge toothbrush combined with oral irrigation, while control group implemented the oral nursing by wiping with cotton ball. We compared the halitosis and modified Beck Oral Assessment Score of patients between two groups. Results The scores of bad breath of patients in observation group one and two weeks after nursing were (1.61±0.64) and (0.69±0.47), and the scores of those in control group were (2.26±0.74) and (1.11±0.58); the differences were statistical (t=-3.92,-3.35;P＜ 0.01). The scores of modified Beck Oral Assessment Score of patients in observation group one and two weeks after nursing were (8.78±1.87) and (6.42±1.27), and the scores of those in control group were (10.94±1.24) and (8.54±0.89);the differences were statistical (t=-5.74,-8.15;P＜ 0.01). Conclusions Disposable medical sponge toothbrush combined with oral irrigation can improve the oral nursing effects of oral tracheal intubation patients and their oral condition.

Objective:To construct a training program based on competency evaluation of clinical nursing teachers.Methods:From August 2019 to July 2020, based on Competency Evaluation Scale, through literature review and expert group discussion, the competency training program for clinical nursing teachers was constructed through expert consultation.Results:The effective recovery rates of the three rounds of expert inquiry were all 100%, the expert authority coefficient was 0.935 and the Kendall coordination coefficients of expert opinions were respectively 0.21, 0.27 and 0.35. The final training program included basic ability training module and advanced ability training module, including 3 modules, 14 projects, 25 courses and 3 modules, 8 projects and 8 courses, respectively.Conclusions:The clinical nursing teacher training program based on the competency evaluation scale is comprehensive and specific in content and it has good practicality, which provides a reference for the training of clinical nursing teachers.

Objective:To establish the norm of clinical nursing teachers' competency in tertiary first-class hospitals in northwest China.Methods:From August 2019 to February 2020, 1 077 clinical nursing teachers were selected from 12 tertiary first-class hospitals in northwest China by stratified, random and proportional sampling, and were investigated with the Clinical Nursing Teacher Competency Evaluation Scale. Descriptive statistics were carried out on the sample data, and univariate variance analysis and pairwise comparison were carried out on the multi-classification variables of age, nursing age, professional title, teaching years and the number of teachers per year. The verified data were exported to SPSS 26.0 for statistical analysis, variance analysis was used for multi-group comparison, and LSD test was used for pairwise comparison between groups.Results:①The corresponding mean norm was established by grouping the total score and the first-class index; the percentile norm was made with 5% spacing; P10, P30, P70 and P90 were selected as the grading demarcation points, and the demarcation norm was constructed. ②Factor analysis showed that there were statistical differences in personality characteristics among different ages, nursing ages and professional titles ( P<0.05), and also in professional attitudes among different nursing ages and professional titles ( P<0.05). Conclusion:The establishment of norm provides references for individuals or units to evaluate teachers' competence.

Objective:To establish a predictive equation for the osmolarity of parenteral nutritional prescription in China.Methods:From July 2019 to September 2019, 2 480 individualized samples of 328 different parenteral nutritional prescriptions (adult) of Peking Union Medical College Hospital were collected, and the osmolarity of parenteral nutritional solution samples was determined by a freezing point reduction method. Pearson χ2 test and a multiple linear regression analysis were utilized to establish a prediction equation for the osmolality of parenteral nutritional solution. Results:The average osmolarity of parenteral nutritional prescription was (1 164.20 ± 252.59) mOsm/kg, and the best fitting equation was (9.66A+ 7.88G+ 3.52F+ 36.4Na+ 27.55K+ 3.38P+ 7.46W-250)/V.Conclusion:The osmolarity is determined accurately and effectively by the fitting equation, which provide a benefit reference for the formulation, review and selection of clinical parenteral nutrition prescription especially in China.