[Objective]To explore the clinical character and the treatment method of wedge-shaped vertebral osteotomy,expanding bone graft and spanning segment pedicle screw-rod system fixation from posterior approach to the thoracolumbar kyphosis caused by old fracture.[Method]From June 2003 to May 2008,26 cases of kyphosis deformity at thoracolumbar segment were treated with wedge-shaped vertebral osteoctomy and long segment pedicle screw-rod internal fixation,including 19 males and 7 females and aging 16-45 years(average age:24.2 years).All kyphosis deformity were caused by old thoracolumbar fracture and patients suffered from back pain.The average disease history were 12.6 years.All the sigittal kyphosis Cobb's angles were more than 40 degree cases.Sixteen patients complicated with nervous symptom.Among them 18 cases were given wedge-shaped vertebral osteoctomy and long segment pedicle screw internal fixation,8 cases were given expanding bone graft in anterior of vertebra after osteotomy.The kyphosis angles from radiographs were given compared between pre-and postoperatively,and complications were given analysis too.[Result]Twenty-two patients had been followed up for 12-48 months(average time:34.6 months),all patients' kyphosis angles were corrected satisfactory,the extend of right angle were 86.45%?4.56%.Besides mesenteric artery compressed syndrome happened in 1 patient,other complication was rare.[Conclusion]This method can correct the kyphosis deformity immediately in operation,its correct extent is large,expanding bone graft in anterior of vertebra after osteotomy can reduce the spine shorten and spinal cord injury rate.

Objective To investigate the status quo of the core competency and organizational commitment of specialized nurses in Jilin province as well as their correlation.Methods Totally 189 specialized nurses in Jilin province were investigated with Competency Inventory for Registered Nurse (CIRN) and Employees' Organizational Commitment Questionnaire (EOCQ).Results The specialized nurses' average score for core competency was (2.98±0.51) in which the leadership score (3.11±0.60), was the highest, while the critical research ability score (2.71±0.61), was the lowest. The EOCQ score was (66.78±8.89) in which the normative commitment score (15.23±2.79), was the highest, while the emotional commitment score (10.54±3.62), was the lowest. Their organizational commitment was positively correlated to core competency (r=0.412,P<0.01). Conclusions The core competency of specialized in Jilin province are relatively high, and stronger core competency helps to improve their organizational commitment.

With the construction and development of head and neck tumor, diagnosis and treatment technology and survival rate of patients have been improved in different degrees. Nurses play an important role as managers and practitioners in the treatment and rehabilitation of patients with head and neck tumors, and it is very important to evaluate and manage the treatment and prognosis of head and neck tumor patients scientifically. In this context, the American Cancer Society launched the Head and Neck Cancer Survivorship Care Guideline in 2017 and was endorsed by the American Society for Clinical Oncology. This paper mainly discusses the forming process of the guidelines, the main points of the consensus of experts, the guiding role of the guidelines in clinical work and the obstacles and limitations of the guidelines.