Objective To investigate the application value of risk management in skin care of hospitalized neurosurgery patients. Methods 179 cases of hospitalized neurosurgical patients from January to December 2011 were chosen as research object.All the patients were divided into the observation group (91 cases,the risk management care group)and the control group (88 cases,the routine care group).The two groups accepted different nursing measures.The skin damage caused by medical factors,family factors and environmental factors for the two groups were taken for statistics and comparison. Results The patients with skin damage due to medical factors,family factors and environmental factors in the observation group were significantly lower than the control group,there was significant difference. Conclusions The application of risk management methods in skin nursing of hospitalized neurosurgery patients has good effect.It can reduce the rate of skin damage of patients significantly and is recommended widely used in hospitalized neurosurgery patients.

Objective To analyze the characteristics and influencing factors of sleep disorders and nocturnal hypoxemia of patients with different degrees of obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Four hundred and twenty-five patients with snoring were scored by Epworth Sleepiness Scale ( ESS), and monitored by polysomnography (PSG). The possible correlations between sleep structure, hypoxia parameters, ESS and clinical features were analyzed and compared in those patients. Results Four hundred and twenty-five patients were divided into 4 groups according to the apnea-hypopnea index (AHI). There were 65 primary snoring patients (15.3%) and 360 OSAHS patients (84. 7% ) including 187 patients (44. 0% ) in severe OSAHS group. ESS was increased as aggravation of OSAHS. There were significant statistical differences in ESS among each group. Compared with primary snoring group, sleep efficiency, NREM1 + 2, oxygen desaturation index ( ODI), time with pulse oxygen saturation below 90% (T(SpO2 <90% ) ) were significantly higher in the OSAHS groups, and NREM3 +4, lowest pulse oxygen saturation level ( LSpO2 ) were lower. ESS was correlated positively with AHI (r= 0. 474,P <0. 01 ). They were both correlated positively with ODI, T (SpO2 <90% ) and NREM1 + 2( ESSr =0. 392, 0. 356,0. 194;AHI r = 0. 714, O. 682, 0. 365, all P < 0. 01 ), and correlated negatively with LSpO2, NREM3 + 4 ( ESS r = - 0. 414, - 0. 196; AHI r = - 0. 740, - 0. 385, both P < 0. 01 ). LSpO2, ODI and T (SpO2 < 90% ) were the primary influencing factors. Common clinical presentations and subjective symptoms were presented including daytime sleepiness, impaired memory, fatigue, dry mouth, oppressive wake and morning headache, etc. Percentage of individuals with daytime sleepiness in the severe OSAHS group was 73. 3% (137/187). These had serious impact on the patients' quality of life, leading to difficulty concentrating, poor memory and cognitive impairment. Conclusions Sleep disorders are found in the patients with different degrees of OSAHS. The excessive daytime sleepiness interrelated partly with the structure of sleep, and totally with hypoxia parameters. The more severity the patients have, the more nocturnal hypoxia, sleep disorders and higher ESS are found.

Objective To study the polymorphism of glucocerebrosidase ( GBA) gene of N370S, V394L, L444P, R120W, R359X, R496H, R353W and RecNcil in the patients with Parkinson's disease ( PD) in Han, Uygur and Kazak in Xinjiang and to investigate the relationship between GBA gene polymorphism and Parkinson's disease.Methods GBA gene polymorphism was analyzed by improved multiplex ligation detection reaction technique in 294 sporadic PD patients (100 cases of Uygur, 134 cases of Han, 60 cases of Kazak) and 305 healthy controls (109 cases of Uygur, 122 cases of Han, 74 cases of Kazak) in Xinjiang area.Results There were two L444P loci polymorphisms that were heterozygous mutations in 294 cases of PD patients and the mutation frequency was 0.7%.Three hundred and five cases of control group did not show L 444P polymorphism.There were no significant differences in L 444P genotype and allele frequency distribution between PD group and control group ( AA:99.3%vs 100.0%, GA:0.7%vs 0, P>0.05;G:0.3%vs 0, A:99.7%vs 100.0%, P>0.05);L444P genotype and allele frequency distribution in Han and Uygur patients with PD showed no significant differences ( AA:99.3% vs 99.0%, GA:0.7%vs 1.0%, P>0.05;G:0.4%vs 0.5%, A:99.6%vs 99.5%,P>0.05);N370S, V394L, R120W, R359X, R496H, R353W, RecNcil loci polymorphisms were not found in the PD and control groups.Conclusion The GBA gene of N370S, V394L, R120W, R359X, R496H, R353W, RecNcil showed no polymorphism in Xinjiang Han and Uygur population and there was no association of L 444P polymorphism with Parkinson's disease in Han and Uygur populations in Xinjiang .

Objective To construct the evaluation index of physical restraint nursing quality for neurosurgical patients,which can guide nurses'clinical practice and continuously improve work flow and quality.Methods Under the guidance of three-dimensional quality structure model,the evaluation index of nursing quality of physical restraint in neurosurgery patients was established by reviewing literature,interviewing experts and using Delphi expert correspondence.Results The effective recovery rate of three rounds of expert enquiry was 100％,the expert authority coefficient was＞0.9,the first and second coordination co-efficients were 0.126 and 0.094(P＜0.001),and the final evaluation index included 3 first-level indicators and 31 second-level indicators.Conclusion The established evaluation indexes are scientific,standardized and comprehensive,which can guide the nursing quality of neurosurgery patients with physical restraint.

This study aims to summarize the clinical features of subarachnoid hemorrhage(SAH)caused by intraspi-nal schwannoma by analyzing 19 cases of intraspinal schwannoma manifesting as SAH who were admitted to our hospital or reported in the literature.The patients in this study had the clinical manifestation of severe headache and vomiting,with-out the symptoms of spinal cord or nerve root compression.Lumbar puncture confirmed SAH,and cerebral digital subtrac-tion angiography did not show intracranial aneurysms or vascular malformations.Spinal cord MRI showed extramedullary intradural tumor in the cervical segment,and pathological biopsy results confirmed the diagnosis of schwannoma.Some cases reported in the literature not only presented with SAH but also had the symptoms of spinal cord and nerve root com-pression.The clinical features of this disease suggest that clinicians should clarify the presence or absence of the symp-toms or signs of nerve root or spinal cord compression in SAH patients with negative intracranial imaging findings and per-form reasonable examinations to exclude intraspinal lesions.Early diagnosis and complete tumor resection can not only pre-vent bleeding and recurrence,but also effectively avoid irreversible damage to the spinal cord and nerve roots caused by the compression of intradural lesions in the spinal canal,thereby helping to improve the prognosis of patients.

Objective To investigate the biomechanical properties of human calcaneus by finite element method. Methods Through CT scanning, Mimics, Geomagic and other software, the finite element model of calcaneus was established. The stress distribution and displacement tendency of calcaneus under normal standing and external force were analyzed. Results Under normal standing, the calcaneal stress was uniformly distributed and small. Under external force, the entire calcaneus stress increased significantly, and the stress on calcaneocuboid articular surface also obviously increased. Conclusions The analysis of the stress and strain distribution on calcaneus in neutral position under different loading, and the investigation on biomechanical properties of calcaneus and mechanism of calcaneal fracture will provide theoretical basis for clinical treatment of calcaneal fractures.