Objective To investigate the usefulness of HC visual laryngoscope designed for unskilled junior emergency resident doctors in respect of increasing the efficiency and success rate of emergency tracheal intubation.Methods A total of 80 patients needed the emergency tracheal intubation were at first divided into two groups randomly (random number).Patients in group A were operated by junior emergency resident doctors and patients in group B were operated by well experienced attending doctors.Then,the two groups of patients above were divided into two groups randomly (random number).Patients in group N were operated with conventional laryngoscope and patients in group HC were managed with HC visual laryngoscope.Then comparisons of the success rate of glottis exposure,the one-time success rate of tracheal intubation,the success rate of tracheal intubation,the complications,the number of attempt in successful intubation cases and the operative time consumed for successful intubation cases among the groups were done.Results (1)The success rate of glottis exposure,the one-time success rate and the success rate of tracheal intubation in group A-HC were 90%,70% and 90%,respectively which were significantly higher than those (50%,20% and 45%)in group A-N (P <0.05).The rate of complication,the number of attempt and operative time consumed for intubation cases in group A-HC were respectively 15%,(1.28 ± 0.43)and (31.44 ±5.06 ) s,which were significantly less than those [45%,(1.89 ±0.79 )and (45.89 ±4.99) s in group A-N (P <0.05 ).(2)The success rate of glottis exposure,the one-time success rate and the success rate of tracheal intubation in group B-N were 80%,65% and 80%, respectively which were significantly higher than those (50%,20% and 45%)in group A-N (P <0.05). The rate of complication,the number of attempt and operative time consumed for successful intubation cases in group B-N were 15%,(1.25 ±0.41)and (39.31 ±4.23)s,respectively which were significantly less than those [45%,(1.89 ±0.79)and (45.89 ±4.99)s]in group A-N (P <0.05).(3)There were no significant statistical differences in above results between group A-HC and group B-HC (P >0.05 ). Conclusions HC visual laryngoscope used by unskilled junior emergency resident doctors for emergency tracheal intubation,could increase success rate of glottis exposure,decrease the number of attempt of intubation,decrease rate of complication,shorten operative time required for intubation thus improving efficiency and success rate of emergency tracheal intubation,and maybe narrow the skill gap between unskilled junior resident doctors and well experienced attending doctors in respect of emergency tracheal intubation.

Through stating the current situation of the doctor -patient relationship , and combining with its characteristics in emergency ICU (EICU), to analyze the application basements and skills of progressive doctor -patient communication in EICU , in order to explore the present stage to build a harmonious doctor -patient rela-tionship , a feasible way to safeguard the rights and interests of both doctors to provide the reference .

Objective:To understand the infection and distribution of syphilis in hospitalized patients, thus to provide reference for syphilis prevention and control.Methods:TP-ELISA test was used to examine early syphilis antibody, and adopted the TPPA test to validation syphilis antibody, and TRUST was used to determine the titer of syphilis antibody in 80 478 hospitalized patients from January 2015 to November 2017, then the results were retrospectively analyzed.Results:Among 80 478 inpatients, 1 326 cases were positive by TP-ELISA test(1 223 cases positive, 101 cases weak positive and 2 cases negative by TPPA confirmed). The positive rates of TP-ELISA in different years were 1.62%(445/27 394), 1.72%(490/28 412) and 1.58%(389/24 672), respectively, and the difference was not statistically significant( P>0.05). The positive rates of male and female patients were 2.02%(689/33 985) and 1.37%(635/46 479), and the difference was statistically significant(χ 2=52.91, P=0.00). The positive rates of ≤18 years old, >18-59 years old, >59-79 years old and>79 years old were 0.32%(7/2 161), 1.44%(765/53 001), 2.31%(488/21 163) and 1.50%(62/4 153), respectively.The highest proportion of syphilis patients was in the group of >59-79 years old, and the differences were statistically significant compared with the other groups(χ 2=37.08, 67.05, 10.80, all P<0.01). Among the TP-ELISA positive patients, 54.90%(728/1 326) had TRUST titer negative, 36.50%(484/1 326) had titer less than 1∶8, and the others had 8.44%(112/1 326). Conclusion:The incidence of syphilis was higher in males than in females in 80 478 hospitalized patients.The highest positive rate was found in >59-79 years old group, and the number of elderly cases increased rapidly.Therefore, the effective interventions should be developed to control the transmission of syphilis according to the epidemiological features.

OBJECTIVES: Patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) confront multiple difficulties during the disease adaptation process. Based on the comprehensive task-based adaptation model, this study aims to explore the process and experience of adapting to living with HIV among HIV/AIDS patients and to provide evidence for promoting the adaptation of this population. METHODS: With the design of the phenomenon study, we purposefully recruited 43 HIV/AIDS patients and conducted semi-structural interviews. The qualitative data was analyzed by Van Manen method. RESULTS: There were 1 307 significant quotes and 6 themes with 14 sub-themes. "The shadow comes along with the sunshine" was proposed to describe the process of adapting to life with HIV. Another 5 themes emerged to represent the tasks as follows: the direction of the mental anchor, the management of physical tasks, social network and support, the occupational dilemma and benefits, and the consideration of the future. CONCLUSIONS The adapting process possesses both common and personalized characteristics. Future intervention development should address the integrality and interaction of the adaptation tasks, contributing to the positive adaptation outcomes of HIV/AIDS patients.
Humans ; Acquired Immunodeficiency Syndrome ; HIV ; Patients ; Physical Examination