Objective To investigate the application of fiberoscope on upper airway compliance in OSAHS patients with MSMSMS. Methods From May 2014 to December 2015,93 patients with OSAHS in Jinhua Central Hospital were detected by MSMSMS[including 32 mild cases (MI),31 moderate cases (MO),and 30 severe cases (SE)] underwent electronic nasopharyngeal examination combined with the Muller test. The course of 93 OSAHS patients were recorded,including body mass index (BMI),sleep apnea index (AHI),mean oxygen saturation. The degree of collapse in the patients' soft palate area,tongue,epiglottis after area were calculated by the software. The results were analyzed by SPSS15. 0 statistical software. Results The disease courses between the mild group and moderate group [(4. 93 ± 2. 91)years,(8. 91 ± 4. 87)years],as well as between the moderate group and severe group [(4. 93 ± 2. 91)years,(9. 27 ± 4. 75) years],had statistically significant differences (t = - 3. 97,P = 0. 001;t =- 4. 33,P < 0. 001). The pairwise intergroup comparison of AHI among the three groups[(7. 75 ± 2. 49) times, (23. 24 ± 3. 74)times,(53. 27 ± 13. 59)times] showed statistically significant differences(t = 15. 49,P = 0. 000;t =- 45. 52,P = 0. 000;t = - 30. 02,P = 0. 000). The differences of MSaO2 between the mild group and severe group [(94. 25 ± 1. 11)％ vs. (94. 45 ± 0. 72)％ ],as well as between the moderate group and severe group[(94. 45 ± 0. 721)％ vs. (91. 40 ± 3. 17)％ ] had statistically significant differences ( t = 2. 85,P = 0. 000;t = 3. 05,P =0. 000). In the SE,there was a positive correlation with mean oxygen saturation (r = 0. 45,P = 0. 007). The collapse of soft palate area among the three groups had statistically significant differences (t = 3. 74,P = 0. 005;t = - 8. 39, P = 0. 000;t = - 4. 65,P = 0. 001). The collapse of posterior tongue area between the moderate group and mild group [(72. 65 ± 1. 56)％ vs. (66. 69 ± 8. 64)％ ],the mild group and severe group[(66. 69 ± 8. 64)％ vs. (74. 33 ± 10. 96)％ ] had statistically significant differences (t = 5. 96,P = 0. 008;t = - 7. 65,P = 0. 001). There was no statistically significant difference between the moderate group and severe group in the collapse of posterior tongue area (P > 0. 05). There were statistically significant differences between the mild group and moderate group[(63. 84 ± 8. 81)％ vs. (75. 06 ± 5. 07)％ ],the mild group and severe group[(63. 84 ± 8. 81)％ vs. (76. 40 ± 7. 94)]in the collapse of epiglottic area (t = 11. 22,P = 0. 000;t = - 12. 56,P = 0. 000). There was no statistically significant difference between the moderate group and severe group in the collapse of epiglottic area(P > 0. 05). Conclusion Fiberoscope combined with Müller test can respond better upper airway compliance in OSAHS patients with MSMSMS. It is worth to promote in clinic.

Objectives:To investigate the prevalence of cough and its influencing factors in community children under 5 years old.Methods:From October to December 2019, we selected 3 102 community children under the age of 5 from 50 natural villages/residential communities in 14 towns/streets of Yiwu, Zhejiang Province, using multi-stage random sampling method. A face-to-face and on-site questionnaire survey was conducted among child caregivers to collect demographic data and information about children′s cough in the last 1 month. Multiple logistic regression model was used to analyze children′s cough and the influencing factors of different cough states.Results:Multivariate logistic regression model analysis results showed that compared with 0-1 year old, dispersed, caregivers with education level below high school, families with 1 child under 5 years old, Cough risk was higher in 1-2, 2-3, 3-4 years old, nurseries, caregivers with education level of high school or above, and families with more than 2 children under 5 years old. OR (95% CI) values were 1.52(1.19-1.92), 1.65(1.29-2.10), 1.86(1.36-2.54), 2.59(1.99-3.38), 1.48(1.26-1.74) and 1.35(1.13-1.62), respectively. Further analysis of the influencing factors of different states of cough, multivariate logistic regression model analysis results showed that preschool status, the number of children under 5 years old in the family and the education level of caregivers were the influencing factors of acute, prolonged and chronic cough. Age was only an influencing factor of acute and persistent cough. Conclusions:The disease burden of cough in children under 5 years old community was heavy, and the cough was related to children′s age, education level of caregivers, number of children under 5 years old in the family and childcare status.

Objectives:To investigate the prevalence of cough and its influencing factors in community children under 5 years old.Methods:From October to December 2019, we selected 3 102 community children under the age of 5 from 50 natural villages/residential communities in 14 towns/streets of Yiwu, Zhejiang Province, using multi-stage random sampling method. A face-to-face and on-site questionnaire survey was conducted among child caregivers to collect demographic data and information about children′s cough in the last 1 month. Multiple logistic regression model was used to analyze children′s cough and the influencing factors of different cough states.Results:Multivariate logistic regression model analysis results showed that compared with 0-1 year old, dispersed, caregivers with education level below high school, families with 1 child under 5 years old, Cough risk was higher in 1-2, 2-3, 3-4 years old, nurseries, caregivers with education level of high school or above, and families with more than 2 children under 5 years old. OR (95% CI) values were 1.52(1.19-1.92), 1.65(1.29-2.10), 1.86(1.36-2.54), 2.59(1.99-3.38), 1.48(1.26-1.74) and 1.35(1.13-1.62), respectively. Further analysis of the influencing factors of different states of cough, multivariate logistic regression model analysis results showed that preschool status, the number of children under 5 years old in the family and the education level of caregivers were the influencing factors of acute, prolonged and chronic cough. Age was only an influencing factor of acute and persistent cough. Conclusions:The disease burden of cough in children under 5 years old community was heavy, and the cough was related to children′s age, education level of caregivers, number of children under 5 years old in the family and childcare status.

Objective:To explore the application effect of flipped classroom combined with simulated case teaching in internship of pediatric nursing students.Methods:In the study, 52 nursing interns having internship in our department from July 2018 to January 2020 were selected and divided into control group and experimental group according to the internship period, including 26 interns in each group. The control group adopted traditional teaching method, while the experimental group adopted flipped classroom teaching method combined with simulated case drill. Indicators such as assessment scores and satisfaction surveys were compared between the two groups.Results:Compared with the control group, the test results of nursing students in the experimental group [(77.077±5.455) points] were significantly better than those [(67.692±4.905) points] in the control group ( P<0.01). The teaching satisfaction of nursing students in the experimental group (99.78%) was significantly better than that (89.92%) in the control group ( P<0.01). Conclusion:The application of flipped classroom combined with simulated case practice teaching method in the internship teaching of pediatric nursing students has achieved good results, which is worthy of promotion in the teaching of pediatric nursing drill.

Objective To develop an expert consensus on subcutaneous injection nursing for allergic asthma in children,standardize nursing practice to reduce the occurrence of related adverse reactions.Methods The clinical guideline,expert consensus,systematic review,evidence summary and original research on subcutaneous injection of monoclonal antibody drug for children with allergic asthma were comprehensively searched in domestic and foreign databases.The time limit for retrieval was from the establishment of databases until August 2023.Combined with clinical practice experience,the first draft of the consensus was formed.From December 2023 to February 2024,27 experts were invited to conduct 2 rounds of expert letter consultation,revise and improve the contents of the first draft,and expert demonstration was conducted,and finally a consensus final draft was formed.Results The effective recovery rate of the 2 rounds of letter consultation questionnaires was 100％;the authority coefficient of experts was 0.88;the judging basis coefficient was 0.93;the familiarity coefficient was 0.83.In the 2 rounds of correspondence,the Kendall concordant coefficients of expert opinions were 0.241 and 0.252,respectively(P＜0.001 for both).The consensus includes 6 parts,including personnel management,environmental layout,indications and contraindications,subcutaneous injection operation norms,identification and treatment of adverse reactions,and health education.Conclusion The consensus is strongly scientific and practical,and can provide guidance for nursing practice of subcutaneous injection of monoclonal antibodies in children with allergic asthma.