Objective To explore the perioperative nursing method and effect of doing minimal invasive occlusion to children with congenital heart disease via subaxillary incision.Methods The data of 86 children patients with congenital heart disease underwent minimally invasive occlusion via right subaxillary incision were retrospectively analyzed and summarized nursing points including preoperative and postoperative mental nursing,postoperative postural care and sedative care,observing whether the occluder moved or detached and mechanical hemolysis,monitoring ECG and blood pressure,and preventing hemorrhage and thrombogenesis.Results One case of infracristal ventricular septal defect with frequent premature ventricular beat after occlusion was converted to thoracotomy surgery;one case of mixed atrial septal defect with heart rate increasing and dyspnea after 12 hours of occlusion was found occluder detached and immediately converted to remove the occluder and fix the atrial septal defect;The other children were successfully recovered and been discharged.Conclusions Full understanding and strengthened perioperative nursing care of complications of children with congenital heart disease after surgical minimally-invasive surgical closure is the key point to avoid the occurrence of fatal complications and ensure the children recover safely and smoothly.

The acupuncture method of Shugan-Tiaoshen is proposed by the famous old Chinese medicine Professor Shan Qiuhua in Shandong Province in combination with Traditional Chinese Medicine theory and clinical experience. Shugan-Tiaoshen acupuncture method is widely used in clinic and has curative effect. It can treat mental diseases, nervous system diseases, digestive system diseases, endocrine system diseases, urinary system diseases, diseases caused by physical and chemical factors and other internal diseases, as well as surgical diseases such as skin trauma, facial symptoms and breast diseases. It can also treat gynecological diseases. It can also improve the brain function of stress disorder. The role of soothing liver and regulating spirit in clinic is never underestimated. In clinical practice, doctors should try their best to combine regulating spirit with treating spirit. Shugan-Tiaoshen acupuncture provides a good idea for clinical treatment, but there are still some problems in the current researches, such as the lack of multi-center, large sample trials, or well-design mechanism researches.

Objective To investigate the value of mammotome minimally invasive puncture drainage in the treatment of breast abscess.Methods 53 patients with the breast abscess were divided into minimally invasive group (27 cases)and open group(26 cases)according to the principle of completely random.The patients in the minimally invasive group were treated with mammotome minimally invasive puncture drainage under the ultrasound guidance.The patients in the open group underwent conventional breast abscess incision and drainage.All the patients were treated with systemic anti -infection and symptomatic treatment.Then,we collated and analyzed the statistical data from the operation time,postoperative pain time,pain degree,number of dressing,healing time,postoperative breast feeding and breast appearance aspects.Results There was no significant difference in operation time between the two groups.In the minimally invasive group,the time of pain,the degree of pain,the time of dressing change,the healing time,the proportion of nursing and the appearance of the breast were (2.6 ±0.8)d,(2.1 ±0.2)min,(7.3 ±0.6)times, (1 8.0 ±0.1 )d,81 .5%,(3.5 ±0.2)points respectively.Those in the open group were (5.2 ±0.2)d,(3.3 ± 0.3)min,(28.0 ±0.2)times,(30.0 ±0.8)d,26.9%,(2.1 ±0.2)points respectively.The differences between the two groups were statistically significant(t =-3.38,-5.1 2,-5.61 ,-5.39,χ2 =32.25,t =-6.1 2,all P <0.05). Conclusion Minimally invasive treatment is a good method in the treatment of breast abscess,and deserved to be promoted clinically.

Objective To investigate the clinical application value of ductoscopic flushing in the treatment of early lactation acute mastitis.Methods 52 patients with early acute mammitis were divided into observation group (27 cases)and control group(25 cases)according to the principle of completely random.In the observation group, the patients were checked under the intervention of mammary duct firstly,and then the disease regions of the breast were flushed using ductoscope.In the control group,the patients were treated with artificial breast -milk.The two groups were all treated with the same antibiotics.The curative effect of the two groups was observed,and the statistical analysis was performed.Results In the observation group,the mass extinction time,pain relief time,pyretolysis time, hemogram recovery time,contralateral continued breast -feeding proportion,the proportion of abscess formation,the proportion of back -milk,the proportion of ipsilateral quadrant recurrence were (3.5 ±1.2)h,(5.0 ±0.9)h, (1.0 ±0.1)d,(1.0 ±0.3)d,92.6%,7.4%,7.4%,0.0% respectively,those in the control group were (24.0 ± 3.2)h,(2.0 ±2.1)h,(2.0 ±0.2)d,(3.0 ±0.3)d,88.0%,12.0%,12.0%,8.0% respectively.The differences between the two groups were statistically significant(t =1.72,0.36,0.43,0.72,χ2 =1.83,2.02,1.56,0.34,all P <0.05).Conclusion Ductoscopic flushing has good effect in the treatment of early lactation acute mastitis,and it is worthy of clinical promotion.

Objective The study was to find the application effect of high quality nursing service in perioperative treatment of patients with coronary heart disease.Methods Eighty patients were randomly divided into the comfort nursing group and the routine nursing group with 40 patients in each group.The comfort nursing group was given high quality nursing service,and the routine nursing group received the conventional care.The effect in two groups was compared after rehabilitation.The statistical software of SPSS 17.0 was used to analyze the data.Results The degree of anxiety was lower,the number of patients with complication was less,the degree of satisfaction was higher and the time in hospital was less in the comfort nursing group.Conclusions The comfortable nursing care should be used in peri-operative treatment of coronary heart disease,which can make patients keep the best mental state to accept and cooperate with the surgical treatment.It also can improve the care quality and patients' satisfaction degree and shorten the hospital stay.

Objective To investigate the effect of stress-related hyperglycemia on myocardial function of patients with cardiac disorder after non-cardiac surgery.Methods The clinical data of 211 patients having undergone thoracic or abdominal operations in Department of Critical Care Medicine of Sun Yat-sen University Cancer Center were retrospectively analyzed. According to the postoperative average blood glucose level in the following 3 days after surgery and the patients' history of cardiac disorder, they were divided into four groups: without hyperglycemia (blood glucose ≤ 10 mmol/L) and cardiac disorder group (HG0CV0 group), without hyperglycemia but with cardiac disorder group (HG0CV1 group), with hyperglycemia (blood glucose > 10 mmol/L) but without cardiac disorder group (HG1CV0 group) and with hyperglycemia and cardiac disorder group (HG1CV1 group). The correlations between the blood glucose and each level of the following items: high-sensitivity cardiac troponin I (hs-cTnI), brain natriuretic peptide (BNP), myocardial zymogram aspartate aminotransferase (AST), creatine kinase (CK), MB isoenzyme of creatine kinase (CK-MB), lactic dehydrogenase (LDH), lactic dehydrogenase isoenzyme (LDH-1), myoglobin (MYO), α- hydroxybutyrate dehydrogenase (HBDH) in each group were analyzed.Results The postoperative blood glucose levels of all 211 patients were significantly higher than those before operation (mmol/L: 8.7±0.2 vs. 5.7±0.2,P < 0.05), and the blood glucose level more than 6.1 mmol/L in postoperative 179 patients accounted for 84.8% of the total. In HG0CV0 group, the postoperative blood glucose level was positively correlated with MYO and AST [r values were 0.193, 0.307; 95% confidence intervals (95%CI) were 0.010 - 0.362, 0.096 - 0.479;P values were 0.038, 0.003]. There were no correlations between postoperative blood glucose level and hs-cTnI, BNP, LDH, LDH-1, HBDH, CK and CK-MB (allP > 0.05). In HG0CV1 group, the postoperative blood glucose level was negatively correlated with hs-cTnI level (r = -0.609, 95%CI = -0.810 to -0.264,P = 0.001). There were no correlations between postoperative blood glucose level and the levels of BNP, MYO, AST, LDH, LDH-1, HBDH, CK and CK-MB (allP > 0.05). In HG1CV0 group, there were no correlations between postoperative blood glucoselevel and hs-cTnI, BNP, MYO, AST, LDH, LDH-1, HBDH, CK and CK-MB (allP > 0.05). In HG1CV1 group, the postoperative blood glucose level was positively correlated with hs-TnI level (r = 0.837, 95%CI = 0.476 - 0.984,P = 0.001). There were no correlations between postoperative blood glucose level and the levels of BNP, MYO, AST, LDH, LDH-1, HBDH, CK and CK-MB (allP > 0.05).Conclusion The early stress-related hyperglycemia after non-cardiac surgery may have a protective effect on myocardial function of patients with cardiac disorder.

Objective To investigate the perioperative nursing Methods of minimally invasive occlusion technique via the right subaxillary route for perimembranous ventricular septal defect in children.Methods A total of 119 patients, who were successfully undergoing minimally invasive occlusion via the right subaxillary route for perimembranous ventricular septal defect from June 2013 to June 2016, were divided into inferior position group (82 cases, adjacent to inflow tract) and superior position group (37 cases, adjacent to outflow tract) according to location of perimembranous ventricular septal defect. Postoperatively complications in patients were compared between two groups. Patients with complications were given individually nursing interventions. Results There were 2 patients from superior position group with occluders displacement post operation. The difference was statistically significant between two groups (P<0.05). A total of 5 patients had extensive subcutaneous emphysema in right chest, 3 patients of which were from inferior position group and other 2 patients were from superior position group. There were 2 patients who had moderate pleural effusion with one for each group respectively. A number of 2 patients was found auscultation of cardiac murmur and one per each group. There was no difference between two groups in the rate of above complications. Occluder was extracted and surgical repair was perfomed in the children with occluders displaccment. Patients with complications were treated in time and then were cured and discharged. Follow-up for all patients ranged from 6.1 months to 24.9 months (13.4±5.0). There was no malignant arrhythmia, device dislocation, hemorrhage, thrombogenesis or other complications.Conclusions The cognition of characteristic of different position in perioperative perimembranous ventricular septal defect occlusion and targeted nursing measures are the key points to avoid lethal complications after surgery for patients and assure the safety of children.

Objective:To summarize the experience of ambulance medical support in the 19th Hangzhou Asian Games, and provide reference for the ambulance medical support work of large-scale sports events in the future.Methods:According to the actual situation of the Asian Games, the objectives of the medical support were determined according to the principles of highlighting the key points and overall consideration. All kinds of ambulances were allocated according to the principles of combining dynamic and static and regional linkage. The ambulance support was divided into the event side and the city side,with the regional security vehicle as the supplement of the event side and the guarantee of the city side, the implementation of "one pavilion one policy", "one game one policy", "one place one policy" and "one vehicle one plan", and the interconnection of medical points (rooms), designated hospitals, management and command personnel and ambulances were realized through the Asian Games Intelligent Emergency Medical Support Syetem (EMSS).Results:Between September 16, 2023, 08:00, and October 9, 2023, 08:00, a total of 207 ambulances were deployed during the 19th Hangzhou Asian Games. Of these, 88 (42.5%) were at competition venues, 11 (5.3%) at training venues, 30 (14.5%) at non-competition venues, and 78 (37.7%) were regional support vehicles. Among them, 20 venue ambulances participated in regional support tasks during idle times. Ambulances transported patients from event sites 345 times, with the highest number of transports occurring at competition venues (187 times) and the fewest in the assisting city of Huzhou (6 times). The highest ambulance utilization rate was 70.5% at competition venues, while training venues, non-competition venues, and regional support ambulances had utilization rates of 45.5%, 53.3%, and 42.3%, respectively. The median age of transported individuals was 26 (21, 36), with a majority being male (59.1%). Athletes comprised 52.5% of transports, while staff and spectators accounted for 39.7% and 7.8%, respectively. Joint injuries were the most common condition among transported individuals, totaling 58 cases (16.8%). Regional support ambulances participated in 75 transfers and replacements, with 17 (22.7%) transfers and 58 (77.3%) replacements.Conclusions:This study confirms the feasibility and efficiency of the Asian Games' ambulance support plan, highlighting the crucial role of EMSS. The study suggests the need to strengthen medical support for staff, in addition to athletes.

BACKGROUNDAn amino acid polymorphism for Met to Val has been identified at PrP codon 129 from different human races. In this study,the characteristics of polymorphism of PRNP 129th amino acid in Han and Uighur Chinese have been investigated.

METHODSHuman DNAs were extracted from peripheral lymphocytes and PrP gene fragments were amplified with a specific PCR protocol. The distribution of 129th amino acid in PRNP was determined by a PCR-RFLP and the results were analyzed with software SAS for Windows 6.12.

RESULTSThe frequencies of the allele 129 Met and 129 Val were 97.0% and 3.0% in Han Chinese, whereas 91.4% and 8.6% in Uighur Chinese. The frequency of 129 M/M phenotypes in Han Chinese was significantly higher than that in Uighur Chinese (P=0.0490). Comparing the phenotype distributions of codon 129 of Han Chinese with that of Japanese and Caucasian, there was significant difference with Caucasian (P=0.0005),but there was no difference with Japanese (P=0.5040).

CONCLUSIONSThe polymorphism of 129th amino acid in PRNP of Han Chinese is similar to Japanese, but different from Uighur Chinese.

Asian Continental Ancestry Group ; genetics ; China ; Codon ; genetics ; European Continental Ancestry Group ; genetics ; Gene Frequency ; Genotype ; Humans ; Polymorphism, Genetic ; Prion Diseases ; genetics ; Prions ; genetics

The United States' just culture plays an important role in patient's safety management, provide the patients with safe, effective and high quality nursing service. This article to the American just culture idea expounds in detail the core content, and just culture is a kind of fair culture and responsibility culture, through three kinds of behavior management, three kinds of responsibility, enhance five kinds of ability, establish the value of a shared responsibility to support system, more conducive to achieve organizational goals. It has a good inspiration and reference to the nursing safety management in our country.