Objective To investigate the gastric contents reflux occurred in the patients in Neurosurgery Intensive Care Unit ( NICU) , and to analyze the risk factors of gastric contents reflux and provide basis for timely and effective nursing intervention measures of clinical practice. Methods A total of 47 patients with mechanical ventilation in NICU of some grade A class three hospitals were collected the data such as age, gender, body posture, state of consciousness, gastric retention, diameter of nasogastric tube, the ballonet pressure of artifical airway and also included samples of throat secretion to test pepsin and pH. Results A total of 235 times watched among 47 patients that the incidence rate of gastric contents reflux was 48. 1%. The single factor analysis showed that there were significant differences of gastric contents reflux between subgroups of different tube diameter, nasal feeding pump rate, gastric retention, Glasgow score and ballonet pressure (χ2 =6. 641, 56. 615, 142. 846, 17. 784, 8. 620;P<0. 05). Further logistic regression analysis indicated that the factors affected gastric contents reflux was nasal feeding pumping rate and gastric retention. Conclusions Gastric contents reflux is a common complication in EN patients in the NICU. According to the Influencing factors, monitoring gastric retention and set proper nasal feeding pump rate is important for continuous nasal feeding patients to reduce gastric contents reflux rate.

Objective:To explore the effect of "medical clown" assisted anesthesia intervention in pediatric surgery.Methods:From May 2018 to May 2020, a total of 1 200 surgical children admitted to the First Affiliated Hospital of Zhengzhou University were selected as the research object. The children were divided into a control group and an observation group with the random number table method, each with 600 cases. The control group completed anesthesia intervention according to the conventional method, and the observation group was given "medical clown" assisted anesthesia intervention. The mean arterial pressure (MAP) , heart rate (HR) , and the modified Face, Legs, Activity, Crying, Consolability (FLACC) score of the two groups of children at different time points were compared. At the same time, the anesthesia Induction Compliance Checklist (ICC) score, and the modified Yale Preoperative Anxiety Scale-Short Form (mYPAS) score of the two groups of children and the satisfaction of the family members with the operation when the child came to the hospital for review one month later were recorded.Results:The MAP, HR, and FLACC scores of the two groups were compared at different time points, and the differences were statistically significant ( P<0.05) . After the intervention, the ICC and mYPAS scores of the observation group were lower than those of the control group, and the satisfaction of the family members of the children was higher than that of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The application of "medical clown" assisted anesthesia intervention in pediatric surgery can stabilize the basic indicators of children, reduce anxiety, and have a high degree of cooperation in anesthesia.

Objective:To investigate changes of hip pain and physical function in patients with osteoarthritis (OA) and analyze the gait and postural factors related to pain progression and functional changes.Methods:From March 2019 to May 2021, a total of 300 patients with OA admitted to the First Affiliated Hospital of Zhengzhou University were consecutively enrolled. The visual analog scale (VAS) and the physical function subscale of the 36-item short form health survey (SF-36) were used to assess hip pain and physical function at enrollment (baseline) and after 12 months of follow-up, respectively. The Vicon 3D motion capture system was used to assess the gait of the patients, and the spinal line angle and mobility in the sagittal plane were measured using a spinal mouse. Linear regression analysis was performed with hip pain and changes in physical function as dependent variables and factors related to gait and standing posture as independent variables. Age, joint space width (JSW) , hip pain and physical function at baseline were adjusted.Results:Linear regression analysis showed that limited hip extension angle [standardized regression coefficient ( β) was -0.52, 95% confidence interval ( CI) : -0.88 to -0.17]and limited hip rotation ( β=-0.51, 95% CI: -0.85 to -0.18) were the influencing factors of hip pain ( P<0.05) . Increased thoracic kyphosis ( β=-0.54, 95% CI: -0.99 to -0.09) , decreased anterior sacral slope ( β=0.40, 95% CI: 0.01 to 0.79) , decreased thoracic range of motion ( β=0.59, 95% CI: 0.23 to 0.94) , decreased daily walking steps ( β=0.53, 95% CI: 0.13 to 0.92 ) and decreased walking speed ( β=0.45, 95% CI: 0.04 to 0.86 ) were the influencing factors of decreased physical function ( P<0.05) . Conclusions:Limited hip extension and external rotation during walking are related factors of hip pain aggravation in patients with OA. Increased thoracic kyphosis, decreased anterior sacral slope, decreased thoracic range of motion, decreased daily walking steps and decreased walking speed are the influencing factors of decreased physical function. It is suggested that nurses should take the above factors as the focus of clinical intervention to prevent the progression of OA.

Objective:To explore the selection of surgical methods for different sites of symptomatic Rathke's cleft cyst (RCC) and the clinical efficacies of these patients.Methods:Forty-seven patients with symptomatic RCC, admitted to our hospital from January 2016 to December 2019, were chosen in our study; 21 patients with intrasellar symptomatic RCC accepted surgery via unilateral nasal approach at the right side, 19 patients with intra-suprasellar symptomatic RCC accepted surgery via bilateral nasal approach, 3 patients with suprasellar symptomatic RCC accepted endonasal transsphenoidal surgery under endoscope, and 4 patients with suprasellar symptomatic RCC accepted craniotomy via pterion approach. The clinical efficacies and complications of patients accepted different surgical methods were compared. All patients were followed up for 3-36 months to observe the recurrence.Results:The postoperative symptoms of the patients were effectively improved, including headache relief ratio of 27/31, vision loss improvement ratio of 5/5, high prolactin relief ratio of 11/13, pituitary function improvement ratio of 9/18. Complications occurred in 6 patients, presenting as diabetes insipidus. Four patients recurred during follow-up.Conclusion:Intrasellar and intra-suprasellar symptomatic RCC accepted surgery via endoscopic transnasal transsphenoidal approach are safe and effective; selection of surgical methods for suprasellar symptomatic RCC should be determined according to the sizes and growth directions of cysts.