Objective To demonstrate the effect of comprehensive treatment under nasal endoscopy for epistaxis. Methods The bleeding sites of 92 patients were defined by nasal endoscopic examination. Epistaxis was cured by single pole or bipolar coagulation, combined with micro packing and systemic treatment. The bleeding sites and effect were studied retrospectively. Results The hemorrhagic foci were found in the following sites: 60.87%(56/92) in Little area, 13.04%(12/92) in the middle and back of nasal septum, 10.87% (10/92) in olfactory sulcus, 8.70% (8/92) in middle turbinate , 3.26% (3/92) at the top of inferior meatus, 2.17% (2/92) at the top of nasal cavity, 1.09% (1/92) at unknown part at the back of nasal cavity. Epistaxis was successfully controlled by once nasal endoscopic examation and hemostasis in 86 of 92 patients. While in 5 of 92 patients, epistaxis was cured by twice nasal endoscopic examation and hemostasis. Endoscopicligation of the sphenopalatineartery was performed in 1 patient with unknown posteriorepistaxis. In 92 patients,15 cases were given micro packing combined with systemic treatment. All the patients were cured and were followed up for 3 months without recurrence and the cure rate was 100.00%. Conclusions The major bleeding site is Little area. Single pole or bipolar coagulation, combined with micro packing and systemic treatment under nasal endoscope is effective for epistaxis and worth of clinic application extensively.

[ABSTRACT]OBJECTIVETo investigate the morbidity rate and the epidemiological characteristics of snoring among the elderly in Yangpu District of Shanghai City.METHODSOne thousand six hundred and thirty persons(≥60 years) were investigated through questionnaires in Yangpu District of Shanghai City by a method of cluster sampling.The prevalence and risk factors of snoring were estimated. The relationship between snoring and the common clinical complications was observed by correlation factor analysis.RESULTS1630 questionnaires were provided, among which 1489 questionnaires(91.35%) were effective for evaluation.Of 1489 subjects, 213(14.3%) subjects had habitual snoring. Multivariate analysis revealed that obesity as a significant risk factor of snoring. The prevalence rate of snoring in the elderly with hypertension and poor quality of sleep was higher than that in the normal elderly.CONCLUSIONThe prevalence of snoring in the elder persons (≥60 years) in Yangpu District of Shanghai City is high. Obesity is a significant risk factor of snoring. The main clinical presentations of snoring in the elderly are atypical by the performance of poor sleep quality and the complication of hypertension.

Objective:To establish a simple and efficient clinical prediction model of moderate and severe obstructive sleep apnea hypopnea (OSAHS) in snoring patients based on the clinical data and morphological measurement data in order to increase the early diagnosis and then early intervention of OSAHS. The prediction model is evaluated by external validation.Methods:A total of 299 subjects from January 2015 to December 2018 were selected to perform polysomngraphy (PSG) in Yangpu Hospital, Tongji University School of Medicine. According to the PSG results, they were divided into moderate and severe OSAHS groups (143 cases) and control groups (156 cases). Clinical complications data and morphological measurement data were collected. The regression equation and ROC curve were established according to the Logistic regression method. Then, another 110 subjects from January 2019 to October 2019 were chosen as verified data group, and used to verify the accuracy of the prediction model. The data of 110 subjects were put into the equation according to risk factors and assignment. The ROC curve was drawn and the area under the curve was calculated. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated.Results:The predicted equation was: y = -10.707 86+0.589 60 × sex+ 0.141 61 × BMI+ 1.281 62 × tonsil size degree+ 1.807 43 × modified Mallampati degree′tongue position. The AUC of the ROC curve of prediction model in training set was 0.851(95% CI 0.807-0.895), the sensitivity was 83.9%, the specificity was 79.5%, and the cut-off value was 0.634.The AUC of the ROC curve in validation set was 0.827(95% CI 0.751-0.904) with a sensitivity of 73.3% and a specificity of 86.0%, and an accuracy of 79.1%. Its positive predictive value was 5.238, and negative predictive value was 0.310. Conclusions:The predictive model constructed by the combination of clinically accessible data (sex) and morphological measurement (BMI, tonsil size degree, modifiedMallampatidegree) has a relatively high predictive efficiency for screening snoring patients with moderate and severe OSAHS. The predictive model is proved with good forecast accuracy by the external verification method.

The paper introduces the necessity of prenatal intervention for diabetes during pregnancy led by specialist nurses. It reviews the content of prenatal intervention for diabetes during pregnancy led by specialist nurses from the fine diet therapy, personalized exercise guidance, standardized drug education, full weight management and monitoring, systematic psychological guidance and other aspects in detail. Besides, this paper puts forward on the deficiencies with the prospect, so as to provide reference for the implementation of prenatal intervention for gestational diabetes mellitus.

Objective:To compile the questionnaire of science and technology education in colleges and universities, conduct a questionnaire survey on the case universities, and summarize the current situation of science and technology education in case colleges and universities.Methods:The convenience sampling method was used to investigate the teachers and undergraduates of a medical university in Guangzhou. Descriptive analysis, one-way ANOVA and multiple comparison analysis were used to analyze the collected data. The reliability and validity of the data were tested by SPSS 20.00.Results:The score of teachers' concept identity [(4.23 ± 0.63) points] was the highest, and the differences in teaching practice dimension among teachers at different ages, with different works, item numbers and course numbers were statistically significant ( P<0.05); the score of students' scientific research demand [(3.65 ± 0.59) points] was the highest, and the scores of environmental support dimension of students in different grades with different credit points were statistically significant ( P<0.01). Conclusion:There are some problems in science and technology education among schools, teachers and students. We try to make improvements from three aspects: building a collaborative platform for science and education, strengthening institutional support and perfecting the evaluation system.

The paper introduced the significance of promoting the early recovery of gastrointestinal function, and the countermeasures to promote the recovery of gastrointestinal function of patients after gynecological laparoscopic surgery from the perspective of rapid rehabilitation. It introduced six aspects including the optimization of diet management, encouragement of early postoperative activities, standardized catheter management, advocated nurses-driven analgesic program, application of the structure of psychological nursing and traditional Chinese medical nursing intervention. Besides, this paper put forward the deficiencies with the prospect, so as to provide references for improving the implementation of gastrointestinal function after gynecological laparoscopic surgery.

This paper introduces the importance of early recognition of ICU-acquired asthenia, illustrates the specific contents of nursing care for ICU-acquired asthenia by rational use of sedation and analgesia strategies, electrical stimulation therapy, early physical activity, functional exercise, music therapy, and intelligent circulatory illumination, and look forward into the inadequacies, in order to provide reference for the sound implementation of nursing care for ICU-acquired asthenia.