Objective To discuss the clinical preventation and treatment of the complications induced by endotracheal intubation in SICU.Methods Retrospective analysis was used on 55 cases of intubated patients in our hospital nearly 2 years.Results The incidence of endotracheal intubation was 36.4％,pneumonia 23.6％,accidental extubation 5.5％,endotracheal ulcer 1.8％,tracheoesophageal fistula 1.8％,obstruction of tracheal catheter 1.8％,arytenoid dislocation 1.8％.Conclusion The causeof complications of endotracheal intubation in SICU were overtime intubation,tranma,excessive-pressure of the air cuff and local inflammation.Airway humidification,suitable sedation,accurate and moderate operation,extubation or tracheotomy,suitable cuff pressure and fiberoptic bronchoscopy examination could avoid such complications.

Objective To understand the incidence.mortality and risk factors of ventilator -associated pneu-monia(VAP)in surgical intensive care unit among elderly patient,in order to direct the clinical prevention and treat-ment of VAP.Methods Retrospective analysis was used on 65 cases of mechanical ventilation elderly patients in our hospital nearly 3 years.Results The incidence of VAP was 66.2%.The mortality of VAP was 67.4%.The factors of long-term mechanical ventilation,high APACHE Ⅱ score,low Glasgow score and inappropriate initial antimicrobial therapy were influenced the prognosis of VAP.Conclusion The incidence of VAP can be decreased and the cure rate can be increased by some effective measures in SICU.

Objective To investigate the status of social adjustment in undergraduate nursing students, and to explore the influence of interpersonal relations and social support on social adjustment. Methods A total of 485 undergraduate nursing students in the School of Nursing of University of South China were investigated by using the Comprehensive Diagnostic Scale for Interpersonal Relations, Social Support Rating Scale and Chinese College Students' Adaptability Scale with stratified cluster sampling method. Results The total scores of social adjustment of undergraduate nursing students were (195.37 ± 26.63) points. The total scores of interpersonal relations were (9.18 ± 5.81) points. The total scores of social support were (36.72 ± 5.39) points. Social support and social adjustment were positively correlated (r=0.274, P<0.01), but interpersonal relations and social adjustment were negatively correlated (r=-0.490, P<0.01). The main influencing factors of social adjustment in a descending order included interpersonal dating(β=-0.390, P=0.000), interpersonal conversation(β=-0.146, P =0.024) and subjective support(β=0.133, P =0.005). Conclusions The scores of the social adjustment, social support and interpersonal relations of undergraduate nursing students are all in the middle level. The main influencing factors of social adjustment include interpersonal dating, interpersonal conversation and subjective support, particulally interpersonal dating. Educators can improve their social adjustment through improving interpersonal dating, interpersonal conversation and subjective support .

18F-flurodeoxyglucose(FDG) PET/CT plays an important role in early diagnosis,clinical staging,therapeutic efficacy evaluation,and recurrence monitoring of colorectal cancer (CRC).More and more scholars have focused on the value of PET/CT in CRC prognosis,intending to find out whether PET/CT can predict the survival outcomes (disease-free survival,progression-free survival and overall survival) of CRC patients after radical resection,in liver metastasis stage or in multiple metastases stage.This review summarizes the clinical value of 18F-FDG PET/CT for the prognosis of CRC.

Objective: To investigate the value of ¹⁸F-fluorodeoxyglucose (FDG) PET/CT in differentiation of noninvasive and malignant pancreatic cystic lesions (PCL). Methods: A total of 125 PCL patients (66 males, 59 females, age range: 13-83 years), who had pathology or typical imaging performance with ≥12 months follow-up between August 2010 and December 2015, were enrolled in this retrospective study. The diagnostic effects of ¹⁸F-FDG PET/CT were calculated. The size, maximum standardized uptake value (SUV_max), delayed SUV_max and retention index (RI) of noninvasive and malignant PCL were analyzed. The results of pathological examination and follow-up were used as the gold standard, and Mann-Whitney u test was used to analyze the data. Receiver operating characteristic (ROC) curves of SUV_max, delayed SUV_max and RI were drawn and compared. Results: A total of 132 PCL were found in 125 patients, including 71 malignant PCL and 61 noninvasive PCL. The size, SUV_max, delayed SUV_max, RI of noninvasive and malignant PLC were 2.2 (1.4, 3.8) cm vs 3.9 (3.0, 5.0) cm, 1.5 (1.2, 1.8) vs 6.4 (4.4, 9.3), 1.5 (1.2, 1.9) vs 6.4 (5.4, 11.7), -6.3%(-19.4%, 5.6%) vs 17.5%(7.6%, 29.4%), respectively. All parameters were significantly different between 2 groups (z values: from -9.267 to -4.904, all P<0.05). The area under curve (AUC) and cut-off value of SUV_max were 0.969 and 2.5, and the corresponding accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) were 92.4%(122/132), 93.0%(66/71), 91.8%(56/61), 93.0%(66/71), 91.8%(56/61), respectively. The AUC and cut-off value of delayed SUV_max were 0.969 and 2.7, and the accuracy, sensitivity, specificity, PPV, NPV were 94.3%(99/105), 96.7%(58/60), 91.1%(41/45), 93.5%(58/62), 95.3%(41/43), respectively. ROC curves of SUV_max and delayed SUV_max were not significantly different (z=1.799, P>0.05). Conclusion ¹⁸F-FDG PET/CT has good performance in differentiation of noninvasive and malignant PCL, but the delayed scan cannot further improve the efficacy of differential diagnosis.

Objective To explore the predictive value of 18F-fluorodeoxyglucose (FDG) PET/CT related metabolic parameters for Kras mutation in colorectal cancer (CRC) patients.Methods Retrospective analysis was conducted in 150 patients (105 males,45 females,median age:63 years) with CRC who underwent 18F-FDG PET/CT in Changhai Hospital of Navy Medical University between November 2011 and August 2017.The primary tumors were removed by surgery and patients received genetic testing within 1 month after PET/CT.18F-FDG PET/CT related metabolic parameters were measured,including maximum standardized uptake value (SUVmax),metabolic tumor volume (MTV;including MTV2.5,MTV20％,MTV30％,MTV40％,MTV50％),total lesion glycolysis (TLG;including TLG2.5,TLG20％,TLG30％,TLG40％,TLG50％).Logistic regression analysis and receiver operating characteristic (ROC) curve analysis were used to analyze the data.Results There were 78 Kras-mutated type patients and 72 wild-type patients.Logistic regression analysis showed that SUVmax (odds ratio (OR) =1.176,95％ CI:1.043-1.327) and MTV2.5 (OR =1.125,95 ％ CI:1.002-1.263) were predictors of Kras mutation.With SUVmax =15.5 and MTV2.5 =23.79 cm3 as the cut-off value,the prediction accuracies of Kras mutation were 67.33％(101/150) and 65.33％(98/150),respectively.The accuracies of SUVmax and MTV2.5 for predicting Kras mutation were higher in recta or sigmoid colon cancers (70.79％(63/89) and 68.54％(61/89)).Conclusion SUVmax and MTV2.5 can predict Kras mutation in CRC patients,but there is a significant gap of predictive efficiency between PET/CT and gene detection.