Objective To compare the effect of midazolam and diasepam in the treatment of patients suffered from serious tetanus and its nursing meaasure.Methods 100 cases of patients suffered from serious tetanus were separately divided into the experimental group and the control group with 50 cases in each group at random.The experimental group Wag sent to basic treatment and nursing with midazolam;the control group wag applied to basic treatment and nursing with diazepam treatment.Patients suffered from hyperspasmia control hard,deep calm and cyanosis were observed in the two groups.Whether their injection sites were painful,phlebitis or vein hardening,abnormal breathing,slow heart mte and death cages were also counted.Results The comparison of the experimental group and the control group showed different hyperspasmia control hard,deep calm,cyanosis,pain,phlebitis or vein hardening,abnormal breathing,slow heart rate,P＜0.05,but no difference was seen in death cases,P＞0.05.Conclusions Midazolam has better effect than diazepam in the treatment of patients suffered from~riOUS tetanus.which is worthy of promoting clinically.

Objective To explore the effect of dietary intervention on treatment effect and life quality of young patients with hepatitis B. Methods 106 cases of hepatitis B patients were randomly divided into the intervention group and the control group, each group with 53 cases. The patients in the control group were given medication treatment and conventional diet, while the intervention group was given medication treatment plus dietary intervention. The therapeutic effect and quality of life were evaluated between the two groups 30 days after the intervention. Results 29 cases in the intervention group were cured (54.72%),while only 16 cases in the control group (30.19%) were cured. The total score of life quality in the intervention group was (69.72 ± 8.42), and (55.71 ± 8.31) in the control group. Significant difference existed in subsequent dimensionality: emotional role, bodily function,bodily pain, vitality, social function, mental health and general health between the two groups. Conclusions Clinical efficacy can be improved and quality of life can be enhanced through dietary intervention in patients with hepatitis B.

[Objective] To observe the effect of Xiangdan injection with the actions of activating blood and removing stasis for the treatment of acute tubular necrosis (ATN) after kidney transplantation. [Methods] Twenty-six patients with ATN after kidney transplantation were randomized into groups A and B. The two groups were treated with triple immuno-suppressive agents of cyclosporin A, prednisone and mycophenolic acid, with medicines for protecting liver function and gastric mucosa, and with preventive measures from infection. Additionally, group A (n = 16) was treated with Xiangdan injection, while group B ( n = 10) was not. After treatment, time for hemodialysis, renal function and renal flow resistance index of the transplanted kidney were compared between the two groups after the occurrence of ATN. [Results] Compared with group B, time for hemodialysis was shortened, the decrease of serum creatine (SCr) in the transplanted kidney quickened, and renal flow resistance index (RI) of the transplanted kidney decreased (P 0.05). [Conclusion] Xiangdan injection with the actions of activating blood and removing stasis can promote the early recovery of ATN after kidney transplantation.

Objective To evaluate the effect of education on the family function of breast reconstruction after breast cancer. Methods Totally 130 cases of breast reconstruction after breast cancer were selected from January 2015 to August 2017, and 65 cases were divided into observation group and control group by random number table method. The control group received routine education; The observation group and the spouse received synchronous education. In the preoperative and postoperative 3 months, 6 months after the Female Sexual Function Index (FSFI) to assess patients sexual function, the Family Intimacy and Adaptability Scale to assess the patient's family intimacy and adaptability, comparing the indicators of two groups of patients. Results After 6 months of operation, the two groups were compared, and the intervention group was (24.82 ± 3.75) points, and the control group was (22.32±4.75), with statistically significant difference(t=- 3.35, P < 0.05). Comparison of familial closeness and adaptability score of the two groups, the intervention group was (76.80 ± 8.14) points, (59.98 ± 3.56) points; The control group was (68.48 ± 11.46) points, (52.27 ± 9.49) points,with statistically significant difference(t=-4.81,-6.18, P<0.05). Conclusion The simultaneous education can improve the sexual function and familial intimacy and adaptability of breast reconstruction after breast cancer.

Objective:To explore the occurrence of symptoms in postoperative patients with oral cancer, and to explore the types and number of symptom groups.Methods:The Anderson symptom assessment scale for head and neck cancer was used to conduct a questionnaire survey on 345 patients after oral cancer surgery. The results of two exploratory factor analysis methods were compared, and the cluster analysis and Spearman rank correlation analysis were combined to determine the symptom group of patients after oral cancer surgery.Results:There were 4 symptom groups in patients with oral cancer, including oral and pharynx symptoms group, dietary and digestive symptoms group, gastrointestinal and emotional symptoms group, and rest activity symptoms group.Conclusions:There are many symptom groups that affect the life of patients with oral cancer in the rehabilitation process after surgery, so the medical staff should carry out targeted intervention mode to achieve better intervention effect.

Objective:To explore the diagnostic value of Caprini score for acute pulmonary embolism(APE).Methods:Totally 2 764 patients with suspected APE admitted to Yuncheng Central Hospital were enrolled from January 2012 to January 2019, and 312 patients were diagnosed APE and assigned to APE group finally.Among the patients without APE, 312 patients(control group) were matched with the patients in APE group according to age, gender, weight, blood pressure, surgical history, etc.The general clinical data of the two groups were collected, and the Caprini score of each patient was recorded.The differences between the two groups in clinical data and Caprini score were compared.The area under curves(AUC) of receiver operating characteristic(ROC) was calculated to predict the diagnostic efficacy of Caprini scale for patients with APE.Results:The Caprini score of the APE group was significantly higher than that of the control group[(5.41±2.47)points vs.(2.16±1.28)points, t=1.180, P=0.004]. The Caprini score had a favorable diagnostic efficacy for patients with suspected APE(AUC=0.915, 95% CI: 0.878-0.995, P<0.001), and when the 3.5 cutoff value of Caprini score was determined, the specificity and sensitivity were 87.76% and 95.24%, respectively, with 7.778 of positive likelihood ratio, 0.054 of negative likelihood ratio, and 0.83 of Youden index. Conclusion:Caprini score has strong diagnostic efficacy in patients with APE.

【Objective】 To establish the reference interval of Thromboelastography(TEG)of healthy adult in Hainan, compare with the interval provided by the manufacturers, and analyze the influencing factors. 【Methods】 A total of 308 healthy adult volunteers were included according to the inclusion and exclusion criteria. The TEG was analyzed based on adequate quality control, and the reference interval of each parameter was calculated with 95% CI. 【Results】 The reference interval of these volunteers were R 4.27~9.20 min, K 1.60~3.83 min, Angle 44.22°~67.78°, MA 47.82~64.17 mm, CI -5.63~1.12 and G 4.58~9.03. 14.94% (46/308) of these volunteers had at least one index exceeded the reference interval provided by manufacturers. A total of 74 healthy volunteers were diagnosed with coagulation disorder, with the specificity at 79.22%. Significant differences of R, K, Angle, MA, CI, G were observed between males and females (P<0.05). Hypercoagulability was not associated with the age. 【Conclusion】 This study established a reference interval of TEG of healthy adults in Hainan, which provided reference for related clinical and basic science study.

Objective:To explore the selection and effects of flap/myocutaneous flap repair methods for the defect after perineum tumor resection.Methods:From January 2011 to February 2017, 31 patients with vulvar tumor who were admitted to Hunan Cancer Hospital underwent repair of wound after tumor resection with various flaps/myocutaneous flaps. The patients were composed of 5 males and 26 females, aged 39-76 years, with 27 vulvar cancer and 4 Paget′s disease in primary diseases. The size of defects after vulvar tumor radical resection ranged from 8.0 cm×4.5 cm to 27.5 cm×24.0 cm. According to the theory of perforasome, the defects were repaired by the external pudendal artery perforator flap, deep inferior epigastric artery perforator flap, rectus abdominis myocutaneous flap, anterolateral thigh flap, internal pudendal artery perforator flap, gracilis myocutaneous flap, and profunda artery perforator flap based on the specific size and location of perineum and groin where the defect was located. According to the blood supply zone of flap, totally 17 local translocation flaps, 18 axial flaps/myocutaneous flaps, and 7 V-Y advancement flaps were resected, with an area of 7.0 cm×4.0 cm to 21.0 cm×13.0 cm. All the flaps/myocutaneous flaps were transferred in pedicled fashion, and the donor sites were closed without tension. The number of flaps/myocutaneous flaps, wound closure, flaps/myocutaneous flaps survival, and follow-up were observed and recorded.Results:Altogether 42 flaps/myocutaneous flaps were harvested in 31 patients. Two flaps/myocutaneous flaps were used in 11 cases for large circular defect repair. All the defects achieved tension-free primary closure. The blood supply of 32 flaps/myocutaneous flaps was good, while insufficient blood supply was noted in the other 10 flaps/myocutaneous flaps. Seventeen flaps/myocutaneous flaps survived smoothly. Wound dehiscence occurred in 5 flaps/myocutaneous flaps 8 to 14 days postoperatively, which was healed with dressing change. Temporary congestion was noted in 7 flaps/myocutaneous flaps 2 to 5 days postoperatively, which recovered without special treatment. Three flaps/myocutaneous flaps had infection 7 to 15 days postoperatively, two of which recovered after dressing change, while the other one had partial necrosis and received debridement and direct closure. Two flaps/myocutaneous flaps were totally necrotic 8 to 15 days postoperatively, which were repaired with pedicled rectus abdominis myocutaneous flap after debridement. Seven flaps/myocutaneous flaps had partial necrosis 7 to 20 days postoperatively and were healed after dressing change. Twenty-four patients were followed up for 9-38 months. The color of flaps/myocutaneous flaps was similar to that of the surrounding skin, the shape of vulva was natural, the movement of hip joint was not limited, the function of micturition and defecation was not affected, and tumor recurrence was noted in 3 patients.Conclusions:For the complicated large defect after perineum tumor resection, the flexible application of different forms of flaps/myocutaneous flaps to repair according to different areas regains the appearance and function. However, there are many complications, so it is necessary to further strengthen the postoperative care.

Objective:To investigate the symptoms of patients with oral cancer during treatment, and explore the types of symptom groups and their correlation with quality of life.Methods:Totally 201 patients with oral cancer after surgery were selected as the subject from a ClassⅢ Grade A hospital using convenient sampling and investigated with the MD Anderson Symptom Inventory for Head and Neck cancer (MDASI-HN) and University of Washington Quality of Life Questionnaire (UW-QOL) , and explore the relationship between them.Results:Totally 189 patients completed the questionnaire. Patients with oral cancer showed many symptoms during the progression and treatment of the disease. Serious symptoms included swallowing, chewing and speaking. Exploratory factor analysis revealed three symptom groups, namely, oral and throat symptom group, drowsiness-digestive tract symptom group, and fatigue-respiratory symptom group. The scores of different dimensions and the total scores of quality of life were negatively correlated with the total scores of the three symptom groups ( P<0.05) . Conclusions:There are multiple symptom groups in patients with oral cancer during postoperative rehabilitation, which seriously affect their quality of life. Medical workers should grasp this characteristic, evaluate symptoms in time, actively manage symptom groups, and improve the quality of life of patients.

【Objective】 To investigate the correlation between preoperative thromboelastography (TEG) parameters and routine coagulation tests of malignant tumor patients. 【Methods】 A total of 79 patients with malignant tumors, receiving preoperative TEG tests and routine coagulation tests between January 2019 and June 2020, were included. The correlation and regression between coagulation indexes and TEG parameters were analyzed. 【Results】 In patients with malignant tumors, the coagulation time(K) was negatively correlated with Plt and fibrinogen (FIB), while Angle, Ma, and G were respectively positively correlated with Plt and FIB. 【Conclusion】 There is a correlation between preoperative TEG parameters and routine coagulation tests in patients with malignant tumors. There is complementarity but not reciprocal substitutability between these two tests.