objective To explore the effect of application of cluster-based strategies on preventing the complication of fibrosclerosis of patients with systemic scleroderma.Methods A total of 59 patients with systemic scleroderma were randomly assigned to the experimental group (34 cases) and the control group (25 cases) during the period of hospitalization in our department.The experimental group took the cluster-based strategies after admission,including a gymnastics,two kinds of respiratory breathing,three kinds of habits,four kinds of protection to prevent the complication of fibrosclerosis.The control group received the conventional care procedures of dermatology.The skin stiffness,joint function,Raynaud's phenomenon and swallowing function were evaluated when patients were admitted and before discharge in two groups.The length of stay between the two groups was also compared.Results The skin stiffness,joint function,Raynaud's phenomenon and swallowing function scored (14.74±1.33),(7.06±0.69),(0.88±0.33),(0.54±0.21) in the experimental group,significantly better than those of the control group,(24.08±1.12),(13.48±0.77),(1.24±0.60),(0.96±0.34),P ＜ 0.01.The length of stay in the experimental group and the control group was (23.65±5.45),(32.00±6.56) days,t=-5.340,P ＜ 0.01.Conclusions Application of cluster-based strategies can be effective against the fibrosclerosis damage of patients with systemic scleroderma and reduce the occurrence of complications.

Objective To explore the effects of application of the new model of evidence-based land humanized nursing in patients with universal pustular psoriasis.Methods Divided 84 patients with universal pustular psoriasis into the experimental group (42 cases) and the control group (42 cases) randomly.Evidence-based questions were raised according to the requests about humanized nursing of patients in the experimental group,and then retrieved and screened literature,sought high-level evidence,combined with previous nursing experience,developed new evidence-based and humanized nursing programs and implemented in the experimental group.The control group used conventional care program.Two weeks after admission,pain,anxiety,depression degree and the complications of two groups were compared.Results Two weeks after admission,the patients with 0 to 5 levels of pain in the experimental group was 0,5,26,7,4 and 0 cases respectively,which in the control group was0,0,0,12,20 and 10 cases respectively,the difference was significant between the two groups (U=6.957,P＜0.01).Anxiety and depression scores in the experimental group was (41.35±4.30) and (42.55±7.71) respectively,which in the control group was (51.31±4.56) and(50.36±6.89) respectively,the difference were significant between the two groups (t=10.540 and 4.893,P＜0.01).Conclusions The new model of evidence-based and humanized nursing can effectively improve the effects of humanized nursing in patients with universal pustular psoriasis.

Objective To investigate the effecs of evidence-based nursing of the treatment with propranolol forthe intractable infantile hemangiomahemangioma. Methods Dividing the children who were treated with propranolol into experimental groups and matched groups randomly according to the random number table each 42 .The experimental group adopted evidence-based care,according to PICO tool description of the problem and combining the results of theresponsibility nurse′s regular follow-up and assessment to come up with evidence-based problems,seeking for high-level evidences,combining the existing conditions of careand having formulated corresponding care norms,contingency plans for adverse reactions,healthy education card,the operation videos and other measures and they are implemented.The control group adopted the routine care procedure.two groups of effects were determined by the Achauer level 4 classification after 12 months of treatment,and evaluating the condition of occur of blood pressure drop ,slow heart beat ,diarrhea, sleepdisorders, hypoglycemia and other adverse reactions in both groups during the process of treatment. Results there was statistical significance in the difference of two groups′Achauer 4 levels. The numbers of Ⅰ, Ⅱ, Ⅲ, and Ⅳ in the two groups were 3, 7, 20, 12, and 11, 15, 11, 5, respectively (t1=1372, t2=2132, P<0.05). The two groups had a statistically significant difference in blood pressure, heart rate, diarrhea, sleep disorder, and low blood sugar response. The numbers of two groups were 12, 2, 3, 6, 1 and 26, 15, 12, 21, 8 respectively (χ2=6.098-12.464, all P<0.05). Conclusions Evidence-based nursing enhances the treatment effectiveness of theintractable infantile hemangioma with propranolol effectively and has preventing the occur of adverse reactions during the process of treatment.

Objective:To explore the value of ultrasound fusion navigation technology in the biopsy of parapharyngeal-infratemporal fossa-skull base (PIS) lesions.Methods:This study was conducted at the First Affiliated Hospital of Sun Yat-Sen University from March 2021 to March 2022 and included 8 patients [3 females and 5 males; age, (50±20) years; range, 16-76 years] with PIS lesions who needed to clarify the pathological diagnosis. The ultrasound fusion navigation with CT or MRI was used to guide lesion biopsy, and the technical feasibility, pathological diagnostic results and complications were evaluated.Results:The biopsy procedures were successful in all 8 patients, and the lesion size ranged from 2.2 to 6.5 cm. The exact pathological diagnosis was obtained in 7 patients, and the diagnostic rate was 87.5% (7/8). No major complication was observed after the biopsy. Mild complications occurred in 1 case, with a incidence of 12.5% (1/8).Conclusions:Ultrasound fusion navigation-guided biopsy is feasible, effective, and safe in the biopsy of deep head and neck lesions.

Objective:To analyze the influence of lifestyle changes on body weight and metabolic parameters during the early stage of corona virus disease 2019 (COVID-19) epidemic and regular epidemic prevention period in physical examination population.Methods:A total of 801 subjects from Nanjing enterprises and institutions who underwent physical examination in the Department of Health Promotion Center, the First Affiliated Hospital of Nanjing Medical University in May of 2019 to 2021 were included in this study. The basic information and data of body mass index, fasting blood glucose, total cholesterol, low density lipoprotein cholesterol (LDL-C), triglyceride and uric acid were collected. Information about dietary and exercise habits was obtained through pre-examination questionnaires. The data of 2019 was set as baseline data, data of 2020 represented information during the early stage of COVID-19 epidemic and data of 2021 represented information in regular epidemic prevention period. The subjects were divided into underweight group, normal weight group, overweight group, and obese group according to the body mass index at baseline. The Friedman test was applied to compare changes in body mass index and metabolic parameters across the population. Chi-square test was used to compare changes in dietary and exercise habits. Multivariate logistic regression analysis was adopted to explore the influencing factors of body mass index changes.Results:During the early stage of COVID-19 epidemic, the proportion of weight gain was the highest in the underweight group (42.9%), the proportion of weight loss was the highest in the overweight group (24.2%), and the obese group has the most stable body weight (70.6%) ( P=0.004). Men ( OR=0.56, 95% CI: 0.36-0.87) were less likely to gain weight than women ( P=0.010). There was no significant differences in weight change among all groups in the regular epidemic prevention period ( P=0.380). During the early stage of COVID-19 epidemic, the levels of fasting blood glucose, total cholesterol and LDL-C were significantly lower than those of baseline [4.98 (4.66, 5.42) vs 5.23 (4.91, 5.66) mmol/L, 4.98 (4.36, 5.67) vs 5.11 (4.54, 5.77) mmol/L, 2.90 (2.45, 3.33) vs 3.23 (2.77, 3.74) mmol/L], and the uric acid level was higher [333.0 (275.5, 397.0) vs 311.0 (257.5, 368.0) μmol/L] (all P<0.001). In regular epidemic prevention period, the levels of body mass index, fasting blood glucose, total cholesterol and LDL-C were significantly higher than those in the early stage of the epidemic [24.0 (21.9, 26.3) vs 23.8 (21.7, 26.1) kg/m 2, 5.18 (4.85, 5.62) vs 4.98 (4.66, 5.42) mmol/L, 5.12 (4.42, 5.76) vs 4.98 (4.36, 5.67) mmol/L, 3.06 (2.59, 3.57) vs 2.90 (2.45, 3.33) mmol/L], while the uric acid was significantly lower [319.0 (265.0, 377.0) vs 333.0 (275.5, 397.0) μmol/L] (all P<0.001). During the early stage of the epidemic, the reduction proportion of unhealthy diet in the home group was significantly higher than that in the outing group (19.5% vs 11.4%), and the increment proportion of exercise in the outing group was significantly higher than that in the home group (5.1% vs 1.6%) (both P<0.05). In regular epidemic prevention period, the increase rate of unhealthy diet in the home group was significantly higher than that in the outing group (26.8% vs 13.0%) ( P<0.001), and there was no significant difference in exercise between the two groups ( P=0.325). During the early stage of COVID-19 epidemic and in the regular epidemic prevention period, unhealthy diet>3 times per week ( OR=3.85, 3.01, 95% CI: 1.74-8.51, 1.41-6.39) was positively correlated with weight gain, and regular exercise ( OR=4.35, 2.61, 95% CI: 2.05-9.23, 1.15-5.91) was positively correlated with weight loss (all P<0.05). Conclusions:During the early stage of COVID-19 epidemic and in the regular epidemic prevention period, the lifestyle in the physical examination population has an impact on body weight and metabolic indicators. In the early stage of the epidemic, unhealthy diet and exercise decreased, and metabolic indicators such as blood glucose and lipids decreased. People with low body weight tend to gain weight. In the regular epidemic prevention period, the subjects′ exercise increased but unhealthy diet also increased, and blood glucose, lipid and body weight elevated significantly.