This paper summarizes the systematic management of artificial airway for 36 postoperative patients with laryngeal cancers. A full-time nurse is responsible for the systematic artificial airway management to implement respiratory care,endotracheal tube care,infection prevention and control,nutritional support and health education. As a result,the incidence of fever,frequent cough,and bloody sputum was 2.12%. Pharyngeal fistula and pulmonary infection occurred in one patient,respectively. All the patients recovered well after intensive care. It is suggested that systematic artificial airway management can effectively reduce complications,improve the quality of nursing and increase patient satisfaction.

Objective Cancer-related fatigue (CRF) is a key in the management of cancer patients' clinic syptoms.This article investigated the status quo of nurses' knowledge and attitude towards CFR.Methods THe method of cross-sectional survey and questionnaire was used to investigate the knowledge and attitude towards CRF among nurses from related departments of three Grade III hospitals in Nanjing.Results 142 nurses answered the questionnaire.The average correct rate was 76.25%, among which nurses from the oncology department had better congition rate than nurses from other medical and surgical departments (84.3%, 75.98%, 79.57%) , representing significant difference (P<0.05).64.79% of the nurses found the relatives of cancer patients and nurses often fail to understand cancer patients;complaint of fatigue, 76.76% of nurses assumed there is lack of communication in fatigue between patients and medical staff.94.36% of nurses agreed medical institutions should strengthen the management of CRF.Conclusion At present, the clinical nurses have inadequate knowledge about CRF, which should be enhanced in future work.

Objective: To construct the management model for intravenous drug use based on index system in a hospital.Methods: A three-level organizational framework was established, the KPI assessment method was used to set control index and observational index respectively for outpatients and inpatients.The completion of the clinical department indicators were monitored and analyzed with the help of the hospital information systems, and regulated by pharmacy and management tools.Results: After the application of the hospital intravenous drug use management model, the qualification rate of intravenous medication orders was improved in December 2015 (89%) when compared with that in December 2014 (68%), and the difference was statistically significant(P＜0.05).The indices of intravenous drug use of inpatients and outpatients in 2015 were significantly improved when compared with those in 2014.Conclusion: The hospital intravenous drug use management model based on index system construction can effectively reduce unnecessary intravenous medication and promote the rationality of intravenous medication.

Objective:To investigate the knowledge of hand-cleaning in student nurses,cultivate their awareness of washing hands,improve their submitting of washing hands and standardize their washing procedure,so as to reduce the hospital-acquired infection via hands.Methods: A self-designed questionnaire on hand-cleaning-related knowledge was used to survey 100 student nurses in their clinical practice in our hospital.Results:In the 100 questionnaires,some student nurses have poor-mastering of the signs of hand-cleaning,and have indefinite concepts of the time,position and frequency of hand-cleaning.The most frequently forgotten part of hands cleaning is finger(42%),the second is wrist(29%).Lots of student nurses(92%) mistakingly thought that washing hands with warm water was much better.Conclusion:The student nurses had relatively poor knowledge on hand-cleaning,much more attention should be paid on the education of this aspect by nursing department,in order to improve self-protection and control of hospital-acquired infection effectively.

Objective: To investigate the absorption of EVA and PVC infusion sets to insulin.Methods: Two infusion sets of EVA and PVC were used to contain insulin which was mixed with TNA and preserved at 4℃ and 25℃ for o,8,24 and 48 h,respectively.The content of insulin was observeed for changes.Results: The content of insulin mixed with TNA in EVA bags was obviously higher than in PVC bags preserved at 25℃ for 48h(P

Objective: To evaluate the self-developed intelligent assist order system for parenteral nutrition on the control of concentration exceeding standard of positive ions.Methods: The special comments, pharmacist audit and information control were used to intervene the concentration exceeding standard of positive ions in parenteral nutrition orders and the effect of the three intervention methods were evaluated.Results: For the intervention of concentration exceeding standard of positive ions in parenteral nutrition orders, the information control was better than the special comments and pharmacists audit.Conclusion: The intelligent assist order system for parenteral nutrition can solve the problem of concentration exceeding standard and promote the rational application of parenteral nutrition in hospitals.

This thesis introduced the situation of the pharmacy administration undergraduate course construction of Shenyang Pharmaceutical University. From the background of setting up of the pharmacy administration program,and in combination with the characteristics of the program,this thesis suggested that five principles should be followed to the course system construction,and expounded the concrete conditions of the curriculum setup and the next step assumption.

Objective There is no quantization scheme for the early ambulation in patients with gastrointestinal tumor after operation of enhanced recovery .The aim of this study was to explore a suitable objective method of postoperative ambulation for gastro -intestinal tumor patients . Methods Sixty six gastrointestinal tumor postoperative patients were randomly assigned to two groups :ex-perimental group ( 33 cases ) and control group ( 33 cases ) .Enhanced recovery was adopted in the both groups afterthe operation . Wireless smart bracelets ( fitbit flex) were used in the experimental group , and the ambulation of patients was monitored by the hand of synchronous real time computer digital panel .At the same time, the patients was supervised for positive ambulation . Traditional quantitative methods of electronic pedometer were used in the control group.The postoperative ambulation , effect and compliance were compared between the two groups . Results Postoperative ambula-tion steps in the experimental group were increased compared with the control group on the days 1, 2, and 3postoperative, and the data were (208.70 ±45.76) vs (144.36 ±47.68), (560.73 ±148.67) vs (407.00 ±85.92), and (894.70 ±91.68) vs (674.00 ±73.06) steps (P<0.05).The first time of early ambulation, flatus, ca-tharsis, and compliance of ambulation showed significant difference in the two groups (P<0.05). Conclusion Wireless intelligent monitoring bracelet is objective and effective for monitoring and quantifying postoperative ambulation .It is superior to the traditional quantitative methods , and can improve the effect and compliance of the ambulation .Moreover , it can promote postoperative recovery in patient with enhanced recovery surgery .

Objective:To evaluate the clinical application value of gastrointestinal contrast-enhanced ultrasound combined gas injection method in verifying the location of nasointestinal tube in critically ill patients.Methods:Data of 60 critically ill patients who had the indications of indwelling nasointestinal tube were collected from September 1,2015 to September 1,2016 in the Intensive Care Unit of Zhejiang Provincial People(s) Hospital.The position of nasointestinal tube in patients who underwent bedside blind insertion would be confirmed routinely through gas injection auscultation method.After tube was inserted,its route was scanned by ultrasound with gas perfusion assistance.Afterwards,rapid gas perfusion was used until suspicious tube end position was determined.Furthermore,oral ultrasound contrast agent was injected into the tube if instantaneous strong echo of gas was observed in localized lumen,and contrast agent filling meant the placement being successful.Two methods of position confirmation of nasointestinal tube in critically ill patients included gastrointestinal contrast enhanced ultrasound combined gas injection and gas injection auscultation only,and the effect of the two methods was compared and confirmed by chest and abdominal X ray examinations to verify the location of nasointestinal tube below pylorus.Results:A total of 60 patients were included in this study,58 patients(96.7％)in gastrointestinal contrast enhanced ultrasound combined gas injection group were successfully positioned.Among them,the placements of tube in 56 cases were below pylorus,while 2 cases were above pylorus.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of location of gastrointestinal contrast enhanced ultrasound combined gas injection method were 96.6％,100％,100％,50％,96.7％ and of gas injection auscultation method were 74.1％,50％,97.7％,6.3％ and 73.3％.The differences of the sensitivity,specificity,negative predictive value and accuracy between the two methods were statistically significant (P ＜ 0.05).Conclusion:Gastrointestinal contrastenhanced ultrasound combined gas injection method is a safe,simple and convenient method with high sen-sitivity,specificity,negative predictive value and accuracy in confirming the location of the nasointestinal tube.

Objective To investigate the management of retroperitoneal infected necrotic tissues in pelvic cavity in patients with severe acute pancreatitis (SAP).Methods The clinical data of 5 patients with SAP complicated with retroperitoneal infected necrotic tissue in the pelvic carvity who were admitted to the General Hospital of Nanjing Military Area from December 2009 to February 2012 were retrospectively analyzed.Systemic comprehensive treatement combined with local management were applied to all the patients.Results Systemic comprehensive treatment:all the 5 patients were treated by enteral nutrition,3 by mechanical ventilation and 3 by continuous blood purification.All the retroperitoneal infected necrotic tissues in the pelvic carvity were treated by computed tomography (CT)-guided percutaneous catheter drainage,and then the patients were converted to open surgery for further drainage.Four patients had complication of infected pancreatic necrosis bleeding,and they were treated by arterial embolism and (or) sandwich therapy.Local management:5 patients with retroperitoneal infected necrotic tissues received CT-guided percutaneous catheter drainage via buttocks.The average time of puncturation after illness was 38.4 days,and the average CT density of infected necrotic tissue was 24.4 Hu (20-28 Hu).Catheterization was successfully done in the open surgery for all the 5 patients,and the average time of abdominal drainage was 21 days.The body temperature and white blood cell count were decreased after puncturation.The average duration of intensive care unite stay,the average time of hospital stay and the average cost of hospitalization were (47 ± 20 )days,(88 ±34 )days and (186 342 ± 15 467 )yuan.All the patients were followed up till May 2012,no recurrece of the retroperitoneal infected necrotic tissue was detected.Conclusion CT-guided percutaneous catheter drainage via buttocks is effective for the treatment of retroperitoneal infected necrotic tissue in the pelvic cavity in SAP patients.