Clavicular crook plate is designed based on anatomic features of acromioclavicular joint,which matches clavicle appearance,and well attaches the shaft.Not passing through the joint,the internal fixation exhibits many advantages,such as convenient usage,reliable fixation and micromovement of fixed acromioclavicular joint.So the patients could move the joint early and avoid osteoarthritis.Allogenous tendon has abundant sources,simple sampling process,and short repairing duration and can reduce injury to patients.Cryopreserved allogenous tendon has low antigenicity and immunological refection,good histocompatibility.Reconstructed coracoclavicular ligament by allogenous tendon has good material intensity,and can meet the requirements of local stress,better substitute integrity and function of coracoclavicular ligament.Moreover,it has precise effect and simple operation.It acts as long-term fixator following plate removal,thus is important supplement of clavicular crook plate fixation.Clavicular crook plate fixation in combination with allogenous tendon transplantation reconstructs acromioclavicular joint stability,effectively provides early mechanical stability and subsequent biological stability,and maximizes restoration of acromioclavicular joint structure and function.

Objective To find out about the epidemiological features of emergency calls around the National Day holiday so as to guide emergency medical services during holidays. Methods An investigation was made into e-mergency cases during the National Day holiday in 2002 (October 1-October 7) as well as one week before and after the holiday and comparison was made between the numbers of emergency cases in the past three years. Results In the past three years, the number of emergency cases around the National Day holiday has been going down year by year whereas at the same time the number of hospitalized patients and patients admitted to the observation ward has been going up. During the National Day holiday in 2002, the number of emergency cases, hospitalized patients and patients admitted to the observation ward increased markedly compared with those before and after the holiday, with the most remarkable increase in the number of pediatric emergency cases and the biggest number of emergency cases in internal medicine. Conclusion It is essential to do a good job of health education and disease prevention, especially among high risk groups of people, and to reinforce the establishment of the emergency medical service system so as to effectively guarantee the development of holiday economy.

Background and purpose:The incidence of liver cancer is high in China. Primary liver cancers usually occur in patients with liver cirrhosis, which is a challenge for the early diagnosis of liver cancer. Our purpose is to investigate the efifcacy of contrast-enhanced ultrasonography (CEUS) in the early identiifcation and diagnosis of small hepatocellular carcinoma (HCC) by regularly tracking and supervising the high risk population. Methods:A total of 320 high risk patients of HCC admitted in our hospital from February 2011 to November 2013 were enrolled in this prospective study. All patients underwent conventional ultrasound and hepatic CEUS. The differential diagnosis of malignant HCCs from benign ones was based on the enhancement patterns of hepatic lesions in different phases on CEUS. Results:Twenty patients were diagnosed as small HCC among 320 HCC high risk patients who were under regular surveillance using CEUS and all were pathologically conifrmed. Seven of the 20 HCC cases were smaller than 1.0 cm and 13 measured 1.1-2.0 cm. There were 6 (30.0%) HCCs presented as“early wash-in and slow wash-out”atypical pattern of HCC. The small size of the lesion and iso-echogenicity were the main factors of atypical pattern of HCC on CEUS.Conclusion:Ultrasonography and CEUS surveillance is a useful strategy for the early detection of small HCCs in high risk patients, which can help them to receive proper therapeutic management in time.

Objective To investigate the effect of atorvastatin on blood lipid and carotid atherosclerosis in patients with hyperlipidemia and cerebral infarction.Methods 98 patients with hyperlipidemia and cerebral in-farction in our hospital from September 2014 to February 2017 were selected and divided into observation group(49 cases)and control group(49 cases)according to the random number table method.The control group was treated with conventional treatment,the observation group was treated with atorvastatin on the ba-sis of the control group.The two groups were treated for 4 weeks.The ADL score,NIHSS score,blood lipid index,carotid IM T and carotid plaque area were compared between the two groups before and after treatment. Results ADL score of the patients in the observation group after treatment higher was than the control group (t=12.7783,P<0.05),NIHSS score was lower than the control group(t=10.941,P<0.05);LDL-C,TC and TG levels after treatment in the observation group were than in the control group(t= 17.239,9.216, 9.800,P<0.05),while the HDL-C level was higher than the control group(t=7.683.P<0.05);the patients in the observation group were treated by carotid artery IM T and carotid plaque area was higher than that of the control group(t=8.919,6.344,P<0.05).Conclusion Atorvastatin can improve hyperlipidemia in pa-tients with cerebral infarction and carotid atherosclerosis,dyslipidemia,has the important research signifi-cance.

This article reviews the relevant researches of cardiac rehabilitation nurses at home and abroad, and summarizes the clinical role, work content, ability training and career development of cardiac rehabilitation nurses in cardiac rehabilitation staging, and aims at providing a reference for the theoretical and practical research of the domestic cardiac rehabilitation nurse training system.

Based on the development process, definition, design types, and application status in the domestic medical and health field of real-world study, this paper explored the current situation and application prospects of real-world study in clinical nursing research, aiming to inspire nursing researchers to explore the current status of real-world nursing based on real-world study concepts, and provide practical basis for the formation of practical guidelines and technical specifications for the high-quality development of clinical nursing, so as to improve the quality of patient nursing services.

Objective:To translate the Decisional Balance Scale for Diabetes Diet (DB-DD) into Chinese, and test its reliability and validity.Methods:After obtaining the authorization of the author of the source scale, the scale was sinicized by translation and back translation method. After expert consultation, cognitive interview and pre-survey for cultural adjustment, the Chinese version of DB-DD scale was formed. From September 2020 to January 2021, a total of 496 patients with type 2 diabetes mellitus in endocrinology department of 4 Class Ⅲ Grade A hospitals in Guangdong province were surveyed by the convenient sampling method to evaluate the reliability and validity of the scale. A total of 496 questionnaires were sent out and 440 were effectively received, with the effective recovery of 88.7%.Results:There were 12 items in the Chinese DB-DD, including 2 dimensions of benefit (6 items) and damage (6 items) . The content validity index of the total scale was 0.98, and the content validity index of the item level was 0.86 to 1.00. The correlation coefficients of the Chinese version of DB-DD total scale, benefit subscale and impairment subscale and diabetes self-management behavior scale were 0.413, 0.222 and -0.221, respectively ( P<0.001) . The Cronbach's α coefficients of the total scale and each subscale were 0.730-0.899 and the split-half reliability coefficients were 0.725-0.856. The test-retest reliability coefficient of the total scale was 0.916 and the test-retest reliability coefficients of the benefit and damage subscales were respectively 0.933 and 0.902. Conclusions:The Chinese version of Decisional Balance Scale for Diabetes Diet has good reliability and validity, which can be used to evaluate the dietary decision balance of diabetic patients in the Chinese cultural context.

Under the policy background of zero addition of drugs and consumables in public hospitals, with clinical practice as the guide and information platform as the means, the hospital constructed an intelligent management system for hospitals′ drugs and consumables through the Internet of things. The hospital adopted the intelligent medicine cabinet extended ward management, consumables " one material, one code" two-level warehouse management mode, reengineering the material supply process.Finally, it can realize the whole process traceability of information, unify the flow of goods and data, save human resources, improve the efficiency of operation and management, and achieve the purpose of ensuring safety, reducing costs and increasing benefits.

Objective:To establish the sensitive quality indicators for cardiovascular nursing based on the RAND Corporation University of California, Los Angeles (RAND-UCLA) expert consensus method, so as to lay the foundation for scientific and standardized quality management of cardiovascular nursing.Methods:Relevant literature was searched on China National Knowledge Infrastructure, WanFang Data, VIP, China Biomedical Literature Database, Cochrane Library, PubMed, EMbase and CINAHL. The search period was from database establishment to August 31, 2021. We used the Johns Hopkins evidence-based nursing practice model for evidence-based analysis and summary, and referred to documents on cardiovascular nursing quality indicators to form an indicator pool. From May 23 to July 12, 2022, 17 experts were selected to apply the RAND-UCLA expert consensus method to inquire about the indicators.Results:The effective response rates of the first and third rounds of the questionnaire were both 100.00% (17/17) , and the authority coefficients of the experts were 0.87 and 0.88, respectively. Among the 18 indicators in the third round of expert consultation, the consistency degree of importance and operability of all indicators was less than 1.00. Finally, 18 sensitive quality indicators for cardiovascular nursing were established.Conclusions:The consistency and coordination of experts in this study are good, and the nursing sensitive indicators formed have scientific characteristics, cardiovascular specialty characteristics, and good operability.

With the continuous advancement of information technology, electronic medical records (EMR) have accumulated vast amounts of clinical data, which can assist nursing staff in making clinical decisions, thereby improving the quality of care, enhancing work efficiency, and promoting patient safety. However, due to varying levels of information technology development across medical institutions, nursing decision support systems (NDSS) remain in a fragmented development stage. This article explores the current application status and existing shortcomings of NDSS based on EMR systems, aiming to provide reference for the design and improvement of NDSS in various levels of medical institutions.