OBJECTIVE To investigate the applicability of 3DMIA software to upper airway modeling in children with obstructive sleep apnea hypopnea syndrome (OSAHS). METHODS A total of 30 children diagnosed with OSAHS by polysomnography were included in this study. Data regarding upper airway structure were collected via spiral CT while sleeping and awake, from which a three-dimensional model of the upper respiratory tract from the nasopharynx to the supraglottic region using 3DMIA software was constructed. The upper airway volume and airway minimum cross-sectional area were measured employing software algorithms. RESULTS The upper airway volume and airway minimum cross-sectional area of the 30 children during sleep were significantly less than those while awake (P<0.01). CONCLUSION 3DMIA software modeling and software algorithm measurement are more objective than traditional radiology (e.g. Fujioka) with respect to evaluation of the extent of the upper airway narrowing in OSAHS children, and has good applicability to study upper airway morphology and function in children with OSAHS.

Objective To survey the scientific research integrity situation of community health care organizations in Yangpu district in Shanghai,meanwhile,provide a reference for scientific research integrity management in any community health care organization.Methods Using the convenience sampling method,we sampled 200 health staff from 4 community health service centers.They were surveyed with uniform questionnaires.Results No dramatically relationship existed in health staff's knowledge about scientific research integrity breach and their age.However,education background,their academic titles,how many times they have learned relative information,publicity about science research integrity would impact their awareness on research integrity.Conclusions There is dramatically discrepancy on the scientific research integrity among these community health staff.

Objective To investigate the effect of applying specialist nursing assessment indicator system on improving nurse′s health assessment ability in orthopedic department. Methods A specialist nursing assessment indicator system was developed by applying evaluation indicators of nursing care quality. That assessment indicator system consisted of 9 sub-indicators. They were assessments on local blood circulation, sensation and motion, muscle strength, pain, risk of developing pressure ulcer, risk of falling down and assessment on anal sphincter function, etc. In addition, standard assessment process was developed and applied to train 54 nurses in orthopedic department, in order to standardize and improve their ability on specialist nursing assessment. Furthermore, the assessment process was transferred into specific nursing interventions to improve nurse′s health assessment ability, too. The accurate rate on those 9 indicated assessments were evaluated and analyzed regularly, pre and post the indicator system application. In the present study, each of the 54 nurses was required to assess five patients basing on the items in the assessment indicator system. The total assessment times were 270. Results After applying the indicator system, the accurate rates of assessments on local blood circulation, sensation and motion, muscle strength, pain, risk of developing pressure ulcer, anal sphincter function and assessment on developing deep venous thrombosis were 98.89% (267/270), 99.63% (269/270), 99.26% (268/270), 97.41% (263/270), 98.15% (265/270), 91.85% (248/270), 98.15% (265/270), which were higher than 95.19%(257/270), 92.96%(251/270), 96.30%(260/270), 90.37%(244/270), 92.22%(249/270), 85.56%(231/270), 92.22%(249/270) of the time when the system was not used, and the difference was significant (χ2=5.34-16.82, P < 0.05). However, the accurate rates on assessing risk of falling down and assessing ADL were not significant different, comparing to the results before applying the indicator system (χ2=0.34, 0.41, P>0.05). Conclusions Applying the specialist nursing assessment indicator system was able to standardize nursing assessment behavior and improve nurse′s assessment ability. In addition, it was beneficial to improve the quality of specialist nursing care in orthopedic department.

Objective To investigate the incidence,pathogenetic factors,prognosis and correlation factors of acute kidney injury(AKI) in the hospitalized elderly patients. Methods The clinical data of 4781 elderly patients (aged 65 years and over) in our hospital from June 2008 to December 2009 were collected in this study using the hospital information system(HIS).The patients with AKI were picked out and were retrospectively analyzed. Results Among 4781patients,515cases (10.8％) suffered from AKI and the incidence of AKI increased with growing age. Single factorial analysis of etiology showed that infections (39.2％) was the most common causes of AKI.Multifactorial analysis revealed that the major causes of AKI were infections (81.0％),followed by hypovolemia (67.2 ％ ),nephrotoxic drugs (64.1％ ),cardiovascular diseases (32.3 ％),respiratory failure(17.7％) and neoplasm (9.5％). Multivariate logistic analysis and cox proportional hazard models indicated multiple organ dysfunction syndrome(MODS),gastrointestinal bleeding,mechanical ventilation and malnutrition were independent risk factors inducing end events such as dialysis or death and influencing time of live. Conclusions There is high incidence of AKI in the elderly hospitalized patient.Infections,hypovolemia,nephrotoxic drugs and cardiovascular diseases are the common causes of AKI.Active treatment of primary diseases,early diagnosis and prevention are beneficial for improving the prognosis of AKI.

Objectives:To investigate the impact on lumbar spine biomechanical performance of endoscopic lumbar interbody fusion(Endo-LIF)via two approaches,namely endoscopic transforaminal lumbar interbody fu-sion(Endo-TLIF)and endoscopic posterior lumbar interbody fusion(Endo-PLIF)through finite element analysis.Methods:The L3-L5 CT scan data of a 24-year-old healthy male volunteer was collected to establish a three-dimensional finite element model containing conical bone,cancellous bone and posterior structure of L3-L5 vertebrae.The validity of the model was verified by comparing with other previous studies.The clini-cal and radiological data of 40 patients underwent Endo-LIF were analyzed retrospectively,and according to different operational approaches,the patients were divided into Endo-TLIF group(n=19)and Endo-PLIF group(n=21).The cage positions and angles of the patients were measured,and the facet joint preservation ratios were calculated to determine the cage placing positions and angles in constructing finite element surgical models.Finally,four finite element surgical models were constructed as Endo-TLIF+45° cage,Endo-TLIF+60° cage,Endo-PLIF+45° cage,and Endo-PLIF+60° cage.The range of motion(ROM)at the fusion segment and the maximum von Mises stress of endplates,cages,screws,rods,and bone-screw interfaces were calculated.Results:The ROMs of fusion segments in all surgical models reduced significantly compared with the intact model.The maximum von Mises stress of endplates in the surgical segment increased significantly under the flexion conditions in all surgical models.The maximum von Mises stress at the bone-screw interfaces of the Endo-PLIF model was significantly increased compared with the Endo-TLIF model under left and right rota-tion conditions(23％-84％).The maximum von Mises stress of the endplate and cage in the 60° cage models was higher than that in the 45° cage models.In the Endo-PLIF model,the stress of internal fixations and endplates was significantly increased compared with the Endo-TLIF model under left and right rotation condi-tions.Conclusions:Comparing with Endo-TLIF,Endo-PLIF has significantly higher maximum von Mises stress around the internal fixations,especially under rotational conditions,with greater risk of internal fixation failure.

After participating in the student selection training and on-site refereeing of the clinical examination skills competition for college students in Sichuan-Chongqing region twice in succession, the author combined the on-site performance and competition results of the participating students with pre-match training experience and normal teaching experience. A comprehensive analysis found that the students' proficiency in basic testing skills, psychological quality and humanistic quality have an important impact on the results of the competition. Teachers should not only pay attention to the quality of basic skills training and theoretical knowledge teaching in practical teaching, but also pay attention to the cultivation of students' teamwork ability and good working habits. Therefore, the clinical laboratory skills competition has a strong leading role in promoting the education and teaching reform of medical laboratory technology and improving the quality of professional practice teaching. It is hoped that more medical colleges and universities will pay attention to and participate in it, and further promote the development of practical teaching of medical laboratory technology.

Child ; Humans ; Pneumonia, Mycoplasma/epidemiology* ; Macrolides/therapeutic use* ; Singapore/epidemiology* ; Child, Hospitalized ; Mycoplasma pneumoniae ; Anti-Bacterial Agents/therapeutic use* ; Drug Resistance, Bacterial ; Community-Acquired Infections/drug therapy*

ICU nursing is a vitalpartof the development of specialized nursing in China, and the standardized training of the corecompetence of ICU nurses is the primary goal of the development of ICU nursing. This paper took the First Affiliated Hospital of Sun Yat-sen University in China and the Royal Free Hospital in London, the United Kingdom as example, and compared the hierarchical management and core competencies training status of ICU nurses in China and England to find out the similarities and differences, and then to put forward valuable suggestions for hierarchical management and the core competence training of ICU nurses in China.

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors of the digestive tract in the world, with high malignancy, strong invasion, high postoperative recurrence rate and low overall survival rate. Transcatheter arterial chemoembolization (TACE) has been recognized as one of the most commonly used local treatment methods for liver cancer. For high risk of recurrence (such as the diameter of the tumor larger (> 5 cm in diameter), preoperative AFP levels, and large vascular invasion, with microvascular invasion, etc.) after radical resection of liver cancer patients, Postoperative adjuvant transarterial chemoembolization (PA-TACE) can bring benefits to the prognosis of patients with liver cancer.At the same time, TACE combined with other therapies such as antiviral therapy, molecular targeted therapy, immunotherapy, ablative radiation therapy and traditional Chinese medicine therapy have shown good efficacy. This article reviews the research progress of adjuvant therapy based on PA-TACE after radical resection of hepatocellular carcinoma.

Objective To investigate the diagnosis and treatment status of sepsis patients admitted to the intensive care unit(ICU)of a large comprehensive hospital.Methods The secondary analysis method of prospective cohort study was conducted to investigate the patients with severe infection admitted to the ICU of Peking Union Medical College Hospital from March 1st 2020 to December 31st 2023,and the patients meeting the diagnostic criteria for sepsis were analyzed.Results For 34months,a total of 11 663 patients with severe in-fection were admitted to the ICU,among whom 4430 patients were diagnosed with sepsis,accounting for 38.0％of the total number of ICU patients.Most sepsis patients were postoperative,and the lung and abdominal cavity were the most common sites of infection.Among the sepsis patients,138 patients died in hospital,and 78 patients were expected to die within 28days after giving up treatment/signing do not resuscitation,with totally 28-day mortality rate of 4.9％(216/4430).Conclusion Sepsis is a common cause of admission to the ICU,with a high incidence rate among ICU patients.This study revealed the current situation and etiological characteristics of sepsis pa-tients in ICU patients with severe infection in large comprehensive hospital.For patients with sepsis,active treatment measures should be taken to improve the survival rate of patients.