Objective To invesgate the effects of comfort care on the quality of life and the curative compliance of elderly patients undergoing hemodialysis.Methods Forty-nine elderly patients undergoing hemodialysis were managed with comfort care including comfortable settings,mental care,and care to arteriovenous fistula and intubated tubes,observation of complications and the related care.The Short Form 36 Health Survey Questionnaire(SF-36)and questionnaire on medical compliance were used for the assessments.Result The scores on SF-36 and medical compliance were both significantly higher than those before the manipulation of comfort nursing(P<0.05).Conclusion Comfort care may be helpful for the improvement of the quality of life and the medical compliance of hemodialysis in elderly patients undergoing hemodialysis.

OBJECTIVE To investigate the risk factors of professional exposure among medical staff and explore the preventive strategies.METHODS The influence of factors including profession,exposure process,exposed materials,treatment process,and follow-up among 110 medical staff with professional exposure was analyzed.RESULTS The general incidence of professional exposure was 52.73%,35.45% and 6.36% for clinical doctors,nures,and workers,respectively.Among all exposure cases,we found the incidence was 62.73% for pricking wound,20% for various liquid contamination,4.55% for glass injury,2.73% for scalpel cutting,and 4.55% for other instrument related damage.The reasons leading to exposure were treatment and nursing care,surgery assistance,and instrument and materials manipulation,which accounted for 40%,31.82%,and 18.18% of total incidence,respectively.All of the exposure cases had been properly treated.None of the investigated cases had been found illed with blood derived transmitted disease caused by professional exposure.CONCLUSIONS It is critical to intensify the training of medical staff for the knowledge of professional exposure and to improve their personal protective awareness,so that the incidence of professional exposure could be reduced.

OBJECTIVE To investigate the antibiotic use during perioperative period in surgery after administration according to Antibiotic Drug Use Guideline.METHODS The antibiotics usage status among 462 outpatient cases in Mar 2005 and 483 cases in Mar 2006 during perioperative period in surgery were surveyed.RESULTS The preventive use rate of antibiotic medication in surgery in 2005 and 2006 were respectively 99.48% and 88.12%(P

Objective To investigate effects of transcranial direct current stimulation on picture naming by those with Broca's aphasia recovering from a stroke.Methods Five patients with Broca's aphasia 6-12 months post-stroke served as their own controls.They all had lesions of the left frontal gyms or the basal ganglia.They received either anodic, cathodic or sham stimulation of the left Broca's area.They were then given a picture naming test.Results The average number of correct namings was 13.13 with anodic stimulation, 9.80 with cathodic and 10.15 with the sham stimulation.Compared with cathodic or sham stimulation, anodic stimulation of the left Broca's area can improve the picture-naming ability of aphasic stroke patients significantly more effectively.Conclusions Anodic stimulation of the left Broca's area can improve the picture-naming of cerebral apoplexy patients with Broca's aphasia.Such stimulation may increase the excitability of the left cortex, suggesting that the left Broca's area and its periphery play a very important role in language recovery after stroke.

OBJECTIVE To offer scientific basis for reasonable usage and management of antibiotics through surveying the situation and problems of antibiotics usage in surgery during perioperative period.METHODS The antibiotics usage status among 462 cases of patients during perioperative period was retrospectively analyzed.RESULTS Antibiotics were used in 460 patients.The rate of prophylactic usage was 83.26%,the rate of therapeutic one was 16.74%;the duration of postoperative prophylaxis was:80.68% of the patients were treated with antibiotics for 4 days or more,the longest one was 28 days;43.26% of the patients received single antibiotic treatment,and 44.13%,11.96%,or 0.65% of patients received 2,3 or 4 kinds of antibiotics combined therapy respectively.CONCLUSIONS Improper application of antibiotics during perioperative period needs higher level administration.

China Three Gorges University(CTGU) started undergraduate medical education for foreign students since 2004. Over the years,through continuous interaction with coordinators,CTGU grad-ually transited from passive teaching to active teaching. Firstly we determined basic principles,objectives and requirements of talent training programme. Secondly,we strengthen Chinese language teaching, reasonably adjusted professional curriculum and teaching content,added basic medical courses and rea-sonably arranged clinical practice based on the concrete situation in our country. in order to make the cur-riculum system consistent with the require-ments of talent training.

Objective To investigate the clinical effects of repetitive transcranial magnetic stimulation (rTMS) combined with body-weight-supported treadmill training (BWSTT) on patients with incomplete spinal cord injury (SCI).Methods Four patients with chronic incomplete SCI participated in this study.They were first treated with rTMS and then BWSTT training.They were assessed with clinical measures of function.Two of the four patients were assessed in terms of their H reflex,and using functional magnetic resonance imaging (fMRI) and a balance performance monitor (BPM).Results In two of the four patients,American spinal injury association (ASIA) clinical measures of motor and sensory function improved,as did 10 m walking speed and their sense of effort.In static balance tests,the sway path and sway area of the two patients both decreased.These improvements lasted for 3 weeks after the intervention.The two patients' maximum H reflex amplitude and the H/M amplitude ratio decreased.The fMRI results showed progressive enlargement of the activation volume of the movement-related M1 region after treatment.Conclusion High-frequency rTMS combined with BWSTT may improve motor function,elevate excitability of spinal motor neurons and improve the plasticity of the cerebral cortex in chronic incomplete SCI patients.

Objective To analyze the topological characteristics of the brain structural network in primary angle-closure glaucoma (PACG) patients by applying graph theoretical approaches.Methods From October 2015 to April 2017, nineteen PACG patients and nineteen gender-and age-matched healthy controls (HCs) were enrolled to undergo MRI scan. The whole brain was parceled into 90 regions by automated anatomical labeling template, and the brain structural network was constructed by the fiber distribution of continuous tracking method.Both the weighted and unweighted network analyses were performed.The global and regional properties were computed by graph theoretical analysis.To compare the brain network regional properties between two groups, two-sample t-test was utilized.The correlations between the brain structural network properties and clinical parameters were further analysed. Results Both two groups were found to follow the efficient small-world characteristics. Compared to HCs, the brain structural network in PACG patients showed no statistical significance in the small-worldness, average shortest path, clustering coefficient, global efficiency and local efficiency(P＞0.05). Compared to the HCs, the PACG patients showed decreased nodal efficiency in the right superior frontal gyrus, right inferior frontal gyrus, left median cingulate and paracingulate gyri, left amygdala and left cuneus(P＜0.05). Compared to HCs, the PACG patients showed decreased node degree in left superior frontal gyrus, medial orbital, right inferior frontal gyrus, left amygdala, left cuneus and left lingual gyrus(P＜0.05). Compared with the hub regions in healthy controls'network, we found that two hub regions disappeared.Those hubs were right inferior parietal lobule and left middle temporal gyrus. Node degree in left amygdala showed negatively correlated with visual ability (r=-0.679, P=0.001). Node degree in left lingual gyrus showed negatively correlated with vertical CDR(r=-0.791, P=0.001),which showed positively correlated with visual acuity(r=0.538, P=0.018).Conclusions The brain structural network in PACG patients showed small-worldness properties as HCs group. The alterations of local properties in visual, emotion-cognition brain regions were observed, manifesting that PACG can affect the topology properties of the structural brain network.

Objective: To investigate the effect of ultrasound transdermal delivery in children with swelling and pain after supracondylar fracture of the humerus. Methods: Totally 103 cases of humeral supracondylar fractures from January to June 2017 were divided into control group (50 cases) and experimental group (53 cases) by random number table method. The control group was treated with conventional detumescence and intravenous drug therapy,while the experimental group was given the local target ultrasonic percutaneous delivery in accordance with the doctor′s advice on the basis of routine treatment. By comparing the two groups in terms of postoperative pain, swelling relief, starting time for getting out of bed, hospitalization time, and parental satisfaction of children, we investigated the effect of ultrasonic ultrasound transdermal delivery on children with swelling and analgesia after supracondylar fracture of the humerus. Results: Postoperative pain relief and swelling relief were significantly reduced in the experimental group compared with the control group, and the difference between the two groups was statistically significant (P<0.05).The time of starting to get out of bed activity and hospitalization were respectively (8.20 ± 0.25) hours and (5.12 ± 0.27) days, and the control group was (23.80 ± 0.15) hours, (7.35 ± 0.38) days, respectively.The comparison was statistically significant (t=24.241, 7.654, all P<0.05). The parents' satisfaction in the experimental group was very satisfied, relatively satisfied, basically satisfied and unsatisfied, respectively 88.68% (47/53), 7.55% (4/53), 3.77% (2/53), 0, the control group was 64.00% (32/50), 26.00% (13/50), 10.00% (5/50), 0(0/50), the difference between the two groups was statistically significant (χ²=5.294 2, P<0.05). Conclusions The accuracy of ultrasonic percutaneous local target placement for the treatment of supracondylar fractures of the humerus in children is effective in the intervention of pain and swelling, and the comfort is better. It is a new choice for the treatment of limb fractures with pain in children.

Objective:To explore the application effect of family-centered empowerment model (FCEM) in rehabilitation nursing of children with femoral shaft fractures treated by skin traction.Methods:A retrospective case-control study was conducted to analyze the clinical data of 107 children with femoral shaft fractures treated with skin traction in Anhui Children′s Hospital from April 2019 to October 2021, including 67 males and 40 females; aged 1.5-5.0 years [2.8(2.0, 3.5)years]. Fracture types included oblique fracture ( n=50), comminuted fracture ( n=26), transverse fracture ( n=14) and spiral fracture ( n=17). FCEM nursing was implemented in 55 patients (family empowerment group) and routine home rehabilitation nursing guidance was performed in 52 patients (routine nursing group). The face, legs, activity, cry, consolability (FLACC) behavioral score on admission and at days 1, 3 and 7 after skin traction, treatment compliance rate at 1 month after skin traction, complication rate at 1 month after skin traction, length of hospital stay and fracture healing time were compared between the two groups. Results:All patients were followed up for 12-18 weeks [13.4(12.7, 13.9)weeks]. There was no significant difference in FLACC behavioral score between the two groups on admission ( P>0.05). The FLACC behavioral score was (4.0±0.7)points,(3.4±0.6)points and (2.4±0.6)points in family empowerment group at days 1, 3 and 7 after skin traction, lower than (4.8±0.7)points, (3.9±0.8)points and (3.3±0.5)points in routine nursing groups (all Ρ<0.01). One month after skin traction, treatment compliance was excellent in 51 patients, good in 4, poor in 0, with treatment compliance rate of 92.7% (51/55) in family empowerment group, and was excellent in 40 patients, good in 9, poor in 3, with treatment compliance rate of 76.9% (40/52) in routine nursing group ( Ρ<0.05). The complication rate was 5.4% (3/55) in family empowerment group, lower than 21.2% (11/52) in routine nursing group ( Ρ<0.05). The length of hospital stay and fracture healing time were (15.6±0.3)days and (7.1±0.8)weeks in family empowerment group, shorter than (16.8±0.3)days and (8.2±0.4)weeks in routine nursing group (all Ρ<0.01). Conclusion:For children with femoral shaft fractures treated by skin traction, nursing using FCEM can alleviate pain, improve treatment compliance, reduce complication rate, reduce hospital stay and shorten fracture healing time.