ObjectiveTo discuss the zero point position of central venous pressure(CVP) by determining the difference of CVP under 45°,90°lateral position and supine position. MethodsThe CVP of 50 cases performed elective surgery undergoing tracheal intubation anesthesia were measured of lateral position and supine position at the same time,the position of the sensor in the chest wall was marked when the CVP values was the same in the two positions by means of moving the sensors,while changes of BP,HR,SpO2,RR were recorded. ResultsThe CVP under right 45°,90° and left 90° lateral position were statistically significant than that under supine position,the CVP under left 45° lateral position was not significanfly different from that under supine position.The zero point under right 45°,90°and left 45°,90°lateral position situated at the left side of the right anterior axillary line (0.8 ± 0.4)cm,the upper side of the right sterna border line (0.8 ± 0.2)cm,the right side of the left anterior axillary line(0.3 ± 0.2)cm,the lower side of the left sternal border line (2.2 ± 0.3)cm. ConclusionsThe zero point position determined by monitoring the changes of CVP under lateral position can not only comfortably measure CVP but also avoid discomfort and complications in patients by forced supine position.

Objective To probe the validity and security of cervical dorsal rand nerve block in posterior approach of cervical vertebra surgery.Methods Eighty-six adults ASA class I-II patients undergohag posterior approach of cervical spine operation randomized equally to cervical dorsal rami nerve block group (group I )and partial infiltration anesthesia group (group II ).In group I ,according to regional anatomy characteristic of the nerve and by means of preopomtively measuring the cervical vertebra X -ray,the body surface projection of articular process joint waist of cervical vertebra were calibrated.Away 3 cm from latter median line,percutaneous puncture via 45° angle relative into sagittal plane ,adopting long 8 cm 7# needle and anesthetic to block ~e surgical incision corresponding bilateral dorsal rami nerves.In group II,using traditional local infiltration anesthesia.The effect and response time of anesthesia,influence on breathing and hemodynamics or pulse oxygen saturation,visual analogue score( VAS ) and calmed grade postoperatively and adverse reaction were observed and recorded.Results The anesthesia excellent rate (74%) in group I was obviously higher than that(42%) in group II (P ＜ 0.05 ).The surgeries average time in group I was less than that in group II,but no statistical significance (P＞ 0.05).The average dose of anesthetic in group I was obviously lower than that in group II (P ＜ 0.01 ).The mean arterial pressure elevated after anesthesia in both groups,and in group I was significantly lower than that in group lI (P ＜ 0.05 ).The SpO2 of both ＞ 95%.Calmed grade and VAS at 24 and 48 h postoperatively were significantly lower in group I than that in group II (P＜ 0.05).There was no adverse reactions.Conclusions Compared to other anesthesia methods in posterior approach of cervical vertebra surgery,the method of cervical dorsal rami nerve block has so undermentioned dominances: simple,less anesthetic,exact effect of anesthesia,light influence on breathing and hemeodynamies and lower injury of spinal cord or spinal nerve root that the method is safe and feasible.

Objective:To study effects of balance and motor function of walking stability training guided by mirror neuron theory for stroke patients with hemiplegia.Methods:A total of 67 stroke with hemiplegia from January 2019 to June 2020 in Heze Municipal Hospital were divided into experimental group (34 cases) and control group (33 cases). All patients were given conventional rehabilitation training, the control group was given body weight support treadmill training, the experimental group was given mirror visual feedback therapy combined with body weight support treadmill training. The training time was 8 weeks. The body balance function, body motor function and life quality were evaluated by Fugl-Meyer Balance scale(FM-B), Berg Balance Scale(BBS), Tinetti Gait Analysis(TGA), Functional Ambulation Category scale(FAC), Stroke-Specific Quality of Life scale (SS-QOL) and compared before and after training between the two groups.Results:There was no significant difference in the score (classification) of FM-B, BBS, TGA, SS-QOL, FAC before training between the two groups( P>0.05). The score (classification) of FM-B, BBS, TGA, FAC after training were (11.35±1.32), (47.33±6.20), (9.32±1.12) points and (3.54±0.61)grades in the experimental group and (9.86±1.25), (42.14±6.35), (8.25±1.32) points and (3.15±0.54) grades in the control group. There were statistically significant of differences( t values were 2.768-4.741, P<0.05). The score of energy, activity ability, emotion, self-care ability, thinking, upper limb function and life quality total score of SS-QOL were (10.31±1.43), (21.46±4.45), (17.64±3.36), (17.32±3.15), (16.23±2.21), (159.11±16.34) points in the experimental group and (8.46±1.21), (17.32±3.24), (15.35±3.11), (14.78±2.32), (8.45±1.25), (13.45±1.54), (141.65±17.24) points in the control group. There were statistically significant of differences( t values were 2.893-7.096, P<0.05). Conclusions:Walking stability training based on mirror neuron theory help to restore limb balance and motor function, and improve life quality in stroke patients with Hemiplegia.