Objective To explore the bias between the real pressure and the measured values when handheld pressure gauge (HPG) was used to monitor intermittently the pressure in the intubation balloon,so as to provide some measures for the correct use of HPG.Methods In the first part of the study,HPG was used to measure the pressure with the balloon connected with a three-way tube with which to control the inflation and deflation in a laboratory to measure the pressure in the air bag.After gaining the deviation in this in vitro experiment,it was tested and verified in vivo in adult patients undergoing endotracheal intubation.Results After 132 times of measurements,it was found that measurement with a HPG might result in an inherent loss (3.928 ± 0.291) cmH2O (1 cmH2O=0.098 kPa,t =155.273,P =0.000) between inflation value [(30.000 ± 0.000) cmH2O] and measured value [(26.072 ± 0.291) cmH2O].In addition,after 214 times repeated measurements,the pressure loss during disconnection of the gauge was as high as (1.196 ± 0.954) cmH2O (t=18.348,P=0.000) between filled values [(30.000 ± 0.000) cmH2O] and measured values [(28.804 ± 0.954) cmH2O] and it was named as error loss.At last,the total error was verified by clinical test,and it was (5.270 ± 2.583) cmH2O (t=29.632,P=0.000) between pressure of filled value [(30.000 ± 0.000) cmH2O] and measured value [(24.730 ± 2.583) cmH2O].Conclusions When the balloon pressure was Monitored intermittently with HPG,the real value should be the measured value plus the error.In addition,subglottic aspiration should be done before the connection of the balloon to the gauge to prevent the secretions on the cuff falls into the deeper airway,and to maintain the cuff pressure at 30 cmH2O.

Objective To explore the application of the transtheoretical model and stages of change in maintenance hemodialysis patients .Methods One hundred and thirty-eight maintenance hemodialysis patients were chosen and received the three stages of interventions according to the transtheoretical model and stages of change.The changes of clinical biochemical indicator were compared before and after the intervention . Results The levels of the serum albumin and hemoglobin were respectively (39.3 ±9.1) g/L, (108.8 ± 11.7)g/L after the intervention, and were significantly higher than (37.2 ±8.3) g/L, (105.6 ±10.4) g/L before the intervention, and the differences were statistically significant (t=-2.002 9, -2.401 4, respectively;P<0.05).The systolic blood pressure, the concentrations of K +and Na +were respectively (148.6 ±20.5) mmHg, (5.5 ±1.4)mmol/L, (146.1 ±16.5)mmol/L before the intervention, and were significantly higher than (141.2 ±22.3)mmHg, (4.9 ±1.3)mmol/L, (139.2 ±20.3)mmol/L after the intervention, and the differences were statistically significant (t=2.869 9, 3.689 3, 3.098 5, respectively; P<0.05).The body weight, blood pressure and the compliance rate of no obvious edema were significantly increased after the intervention (P<0.05).The cases of well nourished patients evaluated by the SGA were 40 cases (44.9%) before the intervention, and were 70 cases (78.7%) after the intervention, and the difference was statistically significant (χ2 =16.49, P<0.05).Conclusions Transtheoretical model and stages of change is beneficial to control blood pressure , improve the prognosis , and increase the life quality of maintenance hemodialysis patients .