Objective To summarize the nursing methods for patients with chronic congestive heart failure treated with local renal nerve block. Methods 10 cases of patients with chronic congestive heart failure were treated with renal nerve block. The blood and urine electrolytes, plasma neuroendocrine hor-mones, the 24-hour urine volume were measured before and after the renal nerve block to calculate the rate of excretion of urinary sodium. The changes of the heart rate and blood pressure and the improvement of the dyspnoea, swelling and other symptoms of heart failure were monitored continuously before and after the re-nal nerve block. Results There was a significant increase in the 24-hour urine volume and the rate of excretion of urinary sodium in the patients with heart failure after the renal nerve block (P<0.05),and there was a significant decrease in the amount of plasma neuroendocrine hormones after the renal nerve block (P<0.01);there was no signifieant changes in the heart rate and the average blood pressure with improvement of dyspnoea, swelling and other symptoms of heart failure. No significant complications were found. Conclusions The nursing measures taken by the nurses in the clinical application of local renal nerve block as a new treatment modality to the treatment of patients with chronic congestive heart failure are safe, effective and feasible.

Objective To report two cases of intestinal perforation in one of monochorionic twins and to analyze relevant clinical manifestations based on literature review. Methods Both cases were admitted to the Obstetrics and Gynecology Hospital of Fudan University in 2017. Relevant articles were retrieved from PubMed, OVID, Elsevier, Full-text Database of China National Knowledge Infrastructure(CNKI) and Wanfang Database from their release dates to February 2018. Clinical manifestations were analyzed through a literature review. Results In case 1, twin boys were born by cesarean section because of selective intrauterine growth restriction (sIUGR) Ⅲ at 31+3gestational weeks. Signs of abdominal distention were found in one boy the day after birth, whose birth weight was 1 440 g and Apgar scores was all 9 at 1, 5 and 10 min after birth. A large amount of intra-abdominal gas was shown on abdominal X-ray. He was cured after surgery and discharged later. The other boy was fine. In case 2, twin girls were born by cesarean section because of twin-twin transfusion syndrome (TTTS) Ⅲ at 29+1gestational weeks. The one suffered from intestinal perforation was 810 g at birth and her Apgar scores was all 8 at 1, 5 and 10 minutes. Pneumoperitoneum were observed on abdominal X-ray 16 h after birth. The baby died because of refusal to further treatment after surgery. The other girl was in good condition. Literature search found no relevant report in mainland China, but ten cases had been reported aboard and five of them died. Most cases of TTTS complicated by intestinal perforation occurred in the recipients. Conclusions Complications of monochorionic twins such as TTTS and sIUGR might be potentially associated with intestinal perforation. Early intervention and evaluation is the key to improve the outcomes.

Objective: To investigate the effect of the lower extremitas abduction brace pads which is designed by our team in helping patient turnover after orthopedic femoral neck fracture, intertrochanteric fracture, femoral head replacement. Methods: Using prospective cohort study to facilitate sampling From October 2016 to August 2017, in an upper third-class hospital of Jiangsu province, we selected 100 patients in Orthopedics dept. No.1 at random as the experimental group and 80 patients in dept. No.2 as the control group. Lower extremitas abduction brace pads were used in experimental group and pillows, backrests and clothes were used in control group. Comfort level, incidence of skin pressure injury, joint dislocation rate and the compliance of the two groups were compared. Results: The number of patients in experimental group who rated the comfort up to 3 (feel a little pain and uncomfortable) was much higher than that in control group (OD value was 5.801, P<0.01), while which rated 1 (feel painful, unbearable and extremely uncomfortable) was lower than that of control group (OD value was 0.168 ,P<0.01) . The ratio of stress injury and dislocation were lower in experimental group (OD value was 0.126, P=0.046). There was no significant difference between two groups in the ratio of dislocation after femoral head replacement (OD value was 0.000, P=0.444) and leg deep vein thrombosis (OD value was 0.000, P=1.000). Conclusion Lower extremitas abduction brace pads can effectively improve the comfort of the patients and reduce the ratio of stress injury.

Objective: To investigate the changes in oropharyngeal airway parameters and hyoid position in skeletal ClassⅡ adult female patients with different vertical skeletal types who were treated with maxillary anterior teeth retraction with maximum anchorage, and to provide a reference for orthodontic clinical diagnosis and treatment. Methods: This study was reviewed and approved by the Medical Ethics Committee, and informed consent was obtained from patients. Sixty adult female patients with skeletal ClassⅡ were selected and divided into a skeletal ClassⅡ normodivergent group and a skeletal ClassⅡ hyperdivergent group based on the patients’ mandibular plane angle. In both groups, the bilateral maxillary first premolars were extracted and the maxillary anterior teeth were retracted with maximum anchorage. Cone beam CT(CBCT) images were collected before and after treatment, and three-dimensional measurement software was used to analyze oropharyngeal airway-related parameters. Results: After retraction of the maxillary anterior teeth with maximum anchorage, the 10 parameters related to the oropharyngeal airway did not exhibit statistically significant differences in the normodivergent group (P>0.05), but the perpendicular distance from the highest point of the hyoid bone to the vertical line passing through the sella (H-X) value decreased (P<0.001). In the hyperdivergent group, the oropharyngeal area at the level of the epiglottis tip (OPA-E), anterior-posterior diameters of the oropharynx at the level of the epiglottis tip (E-AP), most constricted axial area of the oropharynx (OPA-MCA), and anterior-posterior diameters of MCA area of the oropharynx (MCA-AP) decreased after treatment (P<0.001). In addition, the oropharyngeal volume (OPV) decreased after treatment (P<0.05), and the perpendicular distance from the highest point of the hyoid bone to the horizontal line passing through the sella (H-Y) and the highest point of the hyoid bone to the epiglottis base (H-Eb) values increased after treatment (P<0.05). Conclusion After retraction of the maxillary anterior teeth with maximum anchorage, there is no change in the oropharyngeal airway in skeletal ClassⅡ normodivergent female adult patients, while skeletal ClassⅡhyperdivergent female adult patients have a risk of reduction in the oropharyngeal airway after maximuim anchorage retraction of the maxillary anterior teeth.