Objective:To sum up nursing experience of a multi-drug resistant patient with upper gastrointestinal hemorrhage who underwent Lateral skull base.Methods:One patient with multi-drug resistant was admitted to our hospital in October, 2019. To observe and prevent the postoperative complications of lateral skull base and to prevent the rupture bleeding of carotid artery. The early detection and treatment the symptoms of upper gastrointestinal bleeding is effective and necessary. Intervention for patient receiving nutrition therapy is promoted.Results:By giving psychological care to improve patient compliance. The patient had no postoperative complications of lateral skull base, and the bleeding symptoms of upper gastrointestinal hemorrhage was controlled in time.Conclusion:The patient was discharged from the hospital with a tracheal tube in a stable condition.

Objective: To evaluate the effect of a new kind of nasogastric feeding registration form based on energy intake in perioperative nutrition support for patients with oral cancer. Methods: According to the specification of nasal feeding and summarizing the ingredients in common foods, the form was optimized and applied. By the cluster sampling method, the knowledge about energy intake of 12 nurses were investigated before and after the use of the form. The accuracy of energy intake assessment of 5 patients by 12 nurses respectively and the time required for single registration was compared before and after the use. Meanwhile, the knowledge about nasal feeding of 18 patients before the use and 17 patients after the use was compared. Results: The mean score of knowledge about energy intake of nurses was 57.50±17.77 before the use, which was lower than that after the use (89.00 ±6.18), the accuracy rate before the use (61.67%, 37/60) was lower than that after the use (93.33%, 56/60), and the mean time was (18.16 ±6.26) s, which was longer than that after the use (12.65 ±5.67) s (t=17.317, χ²=17.252 and t=22.445 respectively, all P<0.01). The mean score of knowledge about nasal feeding before the use (69.44 ±15.89) was lower than that after the use (86.47±11.15)(t=-3.649, P=0.001). All difference showed statistical significance. Conclusion The nasal feeding registration form based on energy intake is clear and easy to fill out. It can not only help the medical staff calculate the energy intake of patients more accurately, but also help formulate nutritional intervention plan and promote the recovery of patients. Meanwhlie, It shortens the writing time and improves the effect of education. In conclusion, it is worth being popularized.

Objective To study the role of microRNA(miR)-483-3p in reducing myocardial fibrosis in rats,and explore the relationship between its mechanism and autophagy.Methods A total of 24 male SD rats were randomly divided into sham operation group,model group,blank transfec-tion group and high expression group,with 6 rats in each group.The blank transfection group and the high-expression group were pretreated with a single injection of adeno-associated virus(AAV)-blank transfection and AAV-miR-483-3p(5×1011 vg)in the tail vein,respectively.In 14 d later,the sham group was injected with 2.5 ml/(kg·d)normal saline for 14 d,and rat model of myocardial fibrosis was established by 2 mg/ml isoproterenol[2.5 ml/(kg·d)]injection through tail vein for 14 consecutive days.Myocardial pathological damage,severity of myocardial fibrosis,and expression levels of collagen-Ⅰ,microtubule-associated protein light chain 3(LC3),autoph-agy-related protein 5(Atg5)and autophagy degradation substrate(P62)in cardiomyocytes were evaluated and measured.Results Compared with the sham operation group,the model group had obviously larger myocardial fibrosis area,higher positive expression of Collagen-Ⅰ,and increased protein levels of Atg5 and LC3-Ⅱ/LC3-Ⅰ,and decreased expression level of P62 protein(P＜0.05).The myocardial fibrosis area,positive expression of Collagen-Ⅰ,the expression levels of Atg5 and LC3-Ⅱ/LC3-Ⅰ protein[(13.64±1.51)％vs(27.47±1.55)％,(13.48±3.07)％vs(30.91±2.45)％,0.98±0.17 vs 1.24±0.28,0.66±0.05 vs 1.26±0.09,P＜0.05]were significant-ly decreased,and the expression level of P62 was notably increased(0.91±0.11 vs 0.74±0.06,P＜0.05)in the high expression group than the model group.Conclusion MiR-483-3p attenuates myocardial fibrosis in rats,and the mechanism may be related to the inhibition of cardiomyocyte autophagy.

Objective To analyze the clinical characteristics and prognosis of patients with coronary slow flow(CSF)or no reflow(CNR)after emergency PCI.Methods A total of 443 elderly STEMI patients who underwent emergency PCI in Department of Cardiology of the First Affilia-ted Hospital of Tsinghua University from January 2017 to August 2023 were recruited,and ac-cording to thrombolysis in myocardial infarction(TIMI)flow grading after operation,they were divided into CSF/CNR group(TIMI grade≤2 flow,n=40)and normal flow(NCF)group(TIMI grade 3 flow,n=403).Logistic regression analysis was used to analyze the risk factors for CSF/CNR in STEMI patients after PCI.The prognosis was analyzed in the two groups.Results The CSF/CNR group had advanced age,longer durations from onset to admission and from onset to balloon opening,higher mortality rate,and larger proportions of chronic heart failure(CHF),type 2 diabetes mellitus(T2DM),pulse rate＞100 times/min,SBP＜100 mm Hg(1 mm Hg=0.133 kPa),Killip grade＞1,left anterior descending artery disease,LVEF＜50％,and using glycopro-tein Ⅱb/Ⅲa inhibitors and intraaortic balloon counterpulsation,but lower male ratio and DBP when compared with the control group(P＜0.05,P＜0.01).Multiple logistic regression analysis revealed that T2DM(OR=1.320,95％CI:0.618-2.123,P=0.046),mean SBP(OR=1.239,95％CI:0.752-1.525,P=0.04)and SBP＜100 mm Hg(OR=1.330,95％CI:0.836-1.675,P=0.013)were independent risk factors,while male was a protective factor(OR=-1.755,95％CI:-2.338--1.171,P=0.002)for CSF/CNR in STEMI patients after PCI.Conclusion T2DM and lower SBP are independent risk factors,while male is a protective factor for CSF/CNR in STEMI patients after emergency PCI.

Objective:To summarize the case management of promoting the rehabilitation of oral and maxillofacial function of a patient with gingival cancer.Methods:The patient took the obturator prosthesis and orofacial myofunctional therapy to promote the rehabilitation of oral and maxillofacial function. The key points of nursing included: nursing of obturator prosthesis, orofacial myofunctional therapy, psychological nursing and evaluation of oral and maxillofacial function rehabilitation.Results:after one year of case management, the total score of the Chinese version of the obturator functioning scale was 18 points, the mouth opening was 4cm, and the speech distinctness was 98%. The quality of life of the patient was good.Conclusions:When the obturator prosthesis and orofacial myofunctional therapy are taken, all-round cooperation of the medical staff of different specialties from the perioperative period to the discharge follow-up should be strengthened in order to promote the rehabilitation of oral and maxillofacial function.

Objective:To design and evaluate a new type of clothes for patients with reconstruction after oral cancer resection.Methods:According to the characteristics of patients after oral tumor resection and reconstruction, a new type of patient clothing was designed. From January 2018 to June 2018, 79 patients with oral malignant tumor radical resection combined with reconstruction were selected as the control group, using traditional patient clothing. 64 patients with the same operation were selected as the experimental group from July 2018 to December 2018, and the new patient clothing was used. The time of changing clothing, wearing comfort and privacy protection, the convenience for medical staff to observe and change wound dressing were to evaluate.Results:The clothing change time of the patients was (124.00±23.35) s in the experimental group, and (156.09±25.66) s in the control group,the difference was statistically significant( t value was 14.97, P<0.01). The scores of clothing comfort and privacy protection were 8.23±0.91, 7.17±0.94 in the experimental group, and 4.78±0.94, 5.50±0.89 in the control group, the difference were statistically significant( t values were -15.21, -9.95, P<0.01). The scores of medical staff observing wounds and changing wound dressings were 7.88±0.89, 7.87±0.83 in the experimental group, and 4.15±0.78, 4.15±0.78 in the control group, the difference was statistically significant( t values were -18.98, -17.75, P<0.01). Conclusions:The new clothes is effective for patients with reconstruction after oral cancer resection. It can be popularized in patients with oral cancer resection and reconstruction.

Cosmetic and plastic surgery of female external genitalia is a new subject which adopts surgical or non-surgical methods to rectification of vulva and vagina.With the social progress, genitalia plastic surgery has also achieved a dramatic of development, various new technologies has been applied, and women’s genitalia plastic surgery has shown a good prospect. This review focuses on new concepts and techniques of surgery and non-surgical cosmetic surgery of female external genitalia, including the surgical methods, such as mons pubic plasty, clitoral hood plasty, labia minora reduction surgery, labia majora reduction surgery, labia majora augmentation surgery, perineoplasty, vaginoplasty, and non-surgical methods like G-spot augmentation, orgasm shot therapy, photoelectricity-energy based therapy, etc. It could help plastic surgeons and gynecologists to understand the concepts and therapeutics better in this field.

Cosmetic and plastic surgery of female external genitalia is a new subject which adopts surgical or non-surgical methods to rectification of vulva and vagina.With the social progress, genitalia plastic surgery has also achieved a dramatic of development, various new technologies has been applied, and women’s genitalia plastic surgery has shown a good prospect. This review focuses on new concepts and techniques of surgery and non-surgical cosmetic surgery of female external genitalia, including the surgical methods, such as mons pubic plasty, clitoral hood plasty, labia minora reduction surgery, labia majora reduction surgery, labia majora augmentation surgery, perineoplasty, vaginoplasty, and non-surgical methods like G-spot augmentation, orgasm shot therapy, photoelectricity-energy based therapy, etc. It could help plastic surgeons and gynecologists to understand the concepts and therapeutics better in this field.

Objective:To understand the willingness and cognition of nurses in Guangzhou and Foshan to "Internet + Nursing Service", and analyze the relevant factors that affect nurses' willingness so as to provide a reference for the formulation of related policies.Methods:From June to August 2019, convenience sampling was used to selected 625 nurses from 8 hospitals in 2 Class Ⅱ hospitals and 2 Class Ⅲ hospitals in Guangzhou and Foshan respectively as research subjects. All nurses were investigated with the self-designed Nurses' Willingness to "Internet + Nursing Service" Questionnaire. A total of 625 questionnaires were issued and 612 valid questionnaires were returned.Results:Among 612 nurses, only 31.21% (191/612) nurses were willing to carry out "Internet + Nursing Service"; 56.70% (347/612) nurses took a neutral attitude; 78.76% (482/312) nurses were willing to develop "Internet + Nursing Service" with the biggest motivation of increase in economic income. The biggest concern of 90.03% (551/612) nurses was their practice risk and personal safety. Univariate analysis showed that there were statistically significant differences in the willingness of nurses of different ages and working hours to develop "Internet + Nursing Service" (χ 2=11.04, 26.27; P<0.01) . Conclusions:Most nurses take a wait-and-see attitude towards "Internet + Nursing Service". We should improve relevant laws and regulations for nurses as soon as possible to protect the rights and safety of nurses, and attract junior nurses to carry out "Internet + Nursing Service" in a targeted manner.

Objective: To explore the characteristics of perioperative venous therapy in patients undergoing simultaneous repair and reconstruction of oral cancer after radical resection, and prevention of femoral vein catheterization complications, to provide clinical evidence for venous therapy. Methods: A retrospective analysis was perfomed to assess the choice of venous access and its effects in 95 patients undergoing simultaneous reconstruction due to oral cancer during the perioperative period. Results : In total, 95 patients underwent successful indwelling femoral vein catheterization with double lumens, and a midline catheter and peripheral intravenous indwelling needles were used to complete the intravenous therapy after surgery. Among the femoral vein complications, 1 case was complicated with lower extremity venous thrombosis (incidence was 1.1%), and 17 cases were complicated with puncture point bleeding (incidence was17.9%). Two cases of puncture site bleeding were noted among 28 cases using a midline catheter. Local phlebitis and infiltration were the most common complications of peripheral venous catheters. The difference in catheter-related complications among different types of catheters was statistically significant (P < 0.05). The complication rate of the midline catheter was lower than that noted with femoral vein catheterization and peripheral intravenous indwelling needles. Conclusion Based on the treatment characteristics of patients, proper venous catheters should be established during the perioperative period. The application of a femoral vein catheter during the operation combined with the use of a midline catheter and peripheral venous indwelling needles after the operation can satisfy intravenous therapy needs in patients undergoing simultaneous repair and reconstruction for oral cancer, and the midline catheter can effectively reduce venous catheter-related complications.