Objective To observe the application effect of point massage combined with physiotherapy in the treatment of insomnia for community elderly.Methods 30 elderly patients with insomnia who accepted point massage combined with physiotherapy were selected as observation group,and 30 elderly patients treated in tertiary hospital with insomnia who took alprazolamum for treatment were selected as control group.The SRSS score of the two groups before and after treatment,as well as treatment efficacy were compared.Results The insomnia treatment efficacy of the observation group was higher than that of the control group(Z =2.45,P <0.05).The SRSS rating of the observation group before treatment was (30.76 ±7.1 9)points and after treatment was (1 5.43 ±3.95)points.The SRSS rating of the control group before treatment was (32.33 ±6.98)points,which after treatment was (21 .93 ±6.73)points.The SRSS scores of both two groups after treatment were decreased (t =1 0.23,5.87,all P <0.05),with obvious differ-ences.The SRSS scores of the observation group decreased more obviously and was lower than that of the control group (t =4.56,P <0.05).Conclusion The point massage combined with physiotherapy can effectively improve insomnia of the elderly,which is also with advantages of easy operation and no obvious side effects and high cooperation degree etc,and it is suitable to be promoted in community.

Objective To investigate the efficiency and safety of intervention with flexible bronchoscope under general anesthesia by using laryngeal mask in patients with severe tracheal stenosis induced respiratory failure.Methods A total of 16 in-patients with respiratory failure caused by severe tracheal stenosis admitted from September 2009 to March 2012 were retrospectively reviewed.A comprehensive bronchoscopic intervention for the complete patency of airway was successfully performed with various techniques such as cryotherapy,electrocautery,balloon dilatation,and implantation of selfexpanding metal stents under genersl anesthesia by using laryngeal mask.The efficiency of comprehensive bronchoscopic intervention and dyspnea score were evaluated by chest CT scan and bronchoscopic examination before and after the treatment.Data were expressed as ((x-)± s).Paired t test was used for statistical analysis of the data.Results The degrees of tracheal stenosis and dyspnea score before and after intervention were (85.0±8.4)％ vs.(20.9±7.6)％ (P＜0.01) and (3.9±0.3vs.2.4±0.5,P＜ 0.01),respectively.There were no life-threatening complications occurred including massive haemorrhage.Conclusions It is an effective and safe technique to resolve the tracheal stenosis-induced respiratory failure with intervention by using flexible bronchoscope under general anesthesia with laryngeal mask,and it is a promising interventional treatment for clinic application.

Objective:To construct the fault management method(V-SHEL)risk management control model,and to explore its application effect in imaging equipment managing.Methods:Based on the risk assessment,management of imaging equipment and security risk factors of imaging equipment,the V-SHEL risk management and control model was constructed to identify and control the risks of imaging equipment.A total of 20 imaging devices in clinical use the of Tianjin Institute of Traditional Chinese Medicine Affiliated Hospital were selected from 2021 to 2022,and the conventional risk management mode(referred to as conventional management)was adopted during the equipment use period from January to December 2021,and risk management control model based on the V-SHEL risk management and control model(referred to as V-SHEL model management)was adopted during the equipment use period from January to December 2022.The imaging equipment under the two management modes was inspected 120 times respectively.The occurrence of risk events,equipment work quality score,equipment use satisfaction and emergency management time of equipment risk events were compared between the two management modes.Results:The incidence rates of device damage 4 times,missing records 4 times and associated infection 5 times in 120 inspections managed by the V-SHEL model were 3.33%,3.33%and 4.17%,respectively,which were lower than those of the conventional management mode,the difference was statistically significant(x2=11.852,12.904,11.042,P<0.05).The average scores for equipment management,operating status,instrument cleaning,and packaging quality using the V-SHEL model were(90.65±6.25)points,(92.14±5.36)points,(90.14±3.45)points and(94.57±4.36)points,which were higher than those of the conventional management mode,the difference was statistically significant(t=8.382,8.446,12.654,14.443,P<0.05).The average scores of imaging equipment operators on equipment cleanliness,equipment standardization,equipment operation performance and equipment maintenance timeliness managed by the V-SHEL model were(22.36±2.12)points,(21.69±2.37)points,(22.54±1.87)points and(21.59±2.03)points,respectively,which were higher than those of the conventional management mode,the difference was statistically significant(t=14.689,10.481,9.883,10.163,P<0.05).The emergency management time for equipment power safety,diagnosis and treatment safety,biological safety and radiation safety risk events managed by the V-SHEL model was(2.01±0.69)h,(2.03±0.868)h,(3.02±0.96)h,and(2.39±0.96)h,respectively,which were less than those of the conventional management mode,the difference was statistically significant(t=16.394,14.894,15.692,16.519,P<0.05).Conclusion:The V-SHEL risk management model and control manages imaging equipment,which can identify equipment risks,reduce the frequency of imaging equipment failures,improve equipment efficiency,and enhance operator satisfaction.