Objective To investigate the clinical application and effect of micro-planting nail anchorage in orthodontics.Methods Fifty-six patients with oral orthodontic were randomly divided into two groups.29 patients in the observation group were used micro-planting nail anchorage,27 patients in the control group were used the strong non-implant anchorage.Results The reduction of upper incisor inclination and distance in observation group was significantly higher than control group.In another hand,displacement of molars in observation group was significantly lower than control group,the difference was significant(t =9.714,4.491,17.172,all P ＜0.05).Conclusion Micro planting nail can provide the ideal anchorage and orthodontic treatment,and it has the advantages of easy and flexible operation,and it can be instantly afterburner,reliable quality,worthy of clinical application and promotion.

Objective To explore the teaching effects of theory and practice integrated teaching model in small class teaching of ENT nursing. Methods Two classes of nursing students from grade two were randomly selected as experiment group and control group with 120 students in each group. The experiment group was treated with theory and practice integrated teaching model in small class and the control group with traditional practice. The teaching effects of the two groups were compared by test results as well as questionnaire survey . Result The teaching effect in the experiment group was significantly better than that of the control group (P<0.05). Conclusion The theory and practice integrated teaching model in small classes can promote the students' interest in learning and mobilize their initiative and enthusiasm to master theoretical knowledge and specialist skills.

Objective In order to find out certain properate training model for nursing students' ability of general health education.Methods Carried out a one to one teaching model which based on the problem-based learning methods in 900 nursing students,and then evaluated the teaching effects by examination and questionnaire investigation.Results The health education capability of nursing students had promoted significantly,the qualification rate was 100%,nursing students'satisfactory rate for the training model was 100%.Conclusions This training model is feasible and effective in promoting the capability of nursing students in health education.

Huaihua medical College has inquired into the questionnaire from more 500 students who are clinical doctors and graduate nurses and 50 teachs who are clinical teaching hospitals,finding that the results have indicated the significance,the necessity and the actual problems of clinical technical ability practice teaching,when they are in school by their firsthand experience,which are very helpful to shortening scheduled time to practice,improving clinical basic skills,adjusting to medical environment as soon as possible,to ensure practice teaching quality and also have notable effects on continuing reinforcing building the clinical technical ability training centre and improving the quality of clinical technical teaching ability at the same time.

Objective To observe the application effect of procedural sedation and analgesia solution that aiming at shallow sedation in critical patients with mechanical ventilation. Methods Totally 160 patients with mechanical ventilation who accepted endotracheal intubation and without cerebral organic lesions in intensive care unit ( ICU) of our hospital from February 2014 to February 2015 were assigned to the observation group and the control group at random. Patients in the control group received drug sedation and analgesia treatment and the dosage was regulated according to the medication orders; patients in the observation group received the procedural sedation and analgesia solution that aiming at shallow sedation. Doctors made plans and aim of sedation and analgesia, and nurses dynamically evaluated the standard situation of sedation and analgesia and regulated the dosage according to the assessment results. We compared the dosage of sedation drugs, the time of mechanical ventilation, ICU time and the incidence of delirium between two groups.Results The dosage of sedation drugs in the observation group were:disoprofol,(5 690±618.610) mg;dexmedetomidine, (1 642.5± 317.330) μg;the mechanical ventilation time was (4.77±0.740) d, and the ICU time was (5.78±0.750) d. Those data were all lower than the control group (t=9.587,9.523,6.291,6.260;P<0.05). The incidence of delirium was 13.75% in the observation group, and was 26.25% in the control group (χ2=3.91,P<0.05). Conclusions The procedural sedation and analgesia solution that aiming at shallow sedation could effectively reduce the dosage of sedation drugs, shorten the mechanical ventilation time, reduce the incidence of delirium and is worth to popularization and application.

Objective:To quantify the associations between periconceptional maternal homocysteine (HCY) and offspring′s birth weight and risk of small for gestational age (SGA) infant.Methods:The 19 984 mother-child pairs in this prospective cohort study were recruited from the Shanghai preconception cohort; the infants were delivered from 1 st September 2016 to 11 th November 2022. A standardized questionnaire was used to collect the mothers′ demographic information, medical history, dietary supplement use, and maternal complications during pregnancy, and their serum samples were collected. Serum HCY, folate, and vitamin B 12 were measured using chemiluminescent microparticle immunoassay based on serum sample drawn at enrollment. Birth weight data were obtained from medical records. Multiple imputation methods were applied to handle missing data in key variables. Multivariable linear regression and Poisson regression models were used to analyze the relationship between maternal HCY concentration during the periconceptional period and the birth weight and SGA risk of the offspring. Results:A total of 9 452 pairs were enrolled preconceptionally and the remaining 10 532 pairs were enrolled in early pregnancy. The proportion of mothers whose pregnancy age was greater than 35 years was 9.2% (1 832/19 984), the proportion of primiparous women was 76.5% (15 283/19 984), the proportion of pre-pregnancy overweight and obesity was 14.0% (2 804/19 984), the proportion of using folic acid supplements before pregnancy was 21.4% (4 272/19 984), and the proportion of those who supplemented with folic acid during early pregnancy was 85.2% (8 976/10 532); gestational diabetes mellitus was in 6.2% (1 245/19 984), gestational hypertensive syndrome in 3.6% (711/19 984). The birth weight of the offspring was (3 297±468) g, and there were 1 962 SGA children (9.8%). The HCY concentration in the overall population in appropriate for gestational age during the periconceptional period was (7.9±3.2) μmol/L, with (8.3±3.7) μmol/L in the preconception subgroup and (7.3±2.4) μmol/L in the early pregnancy subgroup. After adjustment for the covariates of perinatal demographic information, adverse pregnancy outcomes, serum folate and vitamin B 12, increased maternal periconceptional HCY was significantly associated with lower offspring birth weight ( β=-2.30, 95% CI -4.43--0.16, P=0.035). Only the early pregnancy subgroup was significantly associated with lower offspring birth weight ( β=-7.39, 95% CI-11.50--3.21, P<0.001). No association was found between peripregnancy HCY and offspring SGA risk. However, elevated HCY in early pregnancy was associated with an increased risk of SGA in the offspring ( RR=1.05, 95% CI 1.01-1.08, P=0.002). Periconceptional vitamin B 12 was a mediator of the association between HCY and offspring birth weight, accounting for 16.5%, 41.2% and 5.4% of its total effect in the overall periconceptional population, the pre-pregnancy subgroup and the early pregnancy subgroup, respectively. Conclusions:Maternal periconceptional HCY level is associated with lower birth weight in offspring, but not with the risk of SGA. Elevated maternal HCY in early pregnancy subgroup may be associated with increased risk of SGA in offspring.