Objective:To explore the effect of failure mode and effects analysis (FMEA) on the postoperative complications in patients with cerebral angiography.Methods:Using the convenient sampling method, a total of 167 patients with cerebral angiography who were admitted to Shanxi Provincial People's Hospital from March 2016 to January 2019 were selected as research objects and they were divided into two groups according to the implementation of FMEA. The observation group (after the implementation of FMEA) used FMEA method to calculate of priority risk number (RPN) in failure mode to determine the nursing plan for clinical nursing, while the control group (before the implementation of FMEA) was given routine nursing. The postoperative RPN, complications and nursing satisfaction were compared between the two groups.Results:RPN of each failure mode in the observation group was significantly lower than that in the control group. The total incidence of complications in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.01) . The scores of nursing satisfaction in health education, professional degree of nursing behaviors, nursing requirement satisfaction degree, nursing attitude and nursing skills of the observation group were significantly higher than those of the control group, and the differences were statistically significant ( P<0.01) . Conclusions:FMEA method analyzes the causes of complications of cerebral angiography and formulates targeted nursing plans according to the causes, so as to make the operation process more standardized and scientific, effectively reduce postoperative complications of patients and improve nursing satisfaction.

Objective: To compare the clinical efficacy and safety of bortezomib, cyclophosphamide, dexamethasone (VCD) regimen and bortezomib dexamethasone (VD) regimen in the treatment of the patients with newly diagnosed multiple myeloma (NDMM). Methods: The clinical data of 73 patients with NDMM in Shanxi Dayi Hospital from January 2013 to January 2016 were retrospectively analyzed. According to the chemotherapy regimen, the patients were divided into VCD group (41 cases) and VD group (32 cases). The efficacy and adverse reactions of the two groups were evaluated. Results: The overall response rate of VCD group and VD group was 80.5% (33/41) and 78.1% (25/32) respectively, and the difference was not statistically significant (χ ²= 0.061, P= 0.804); and complete remission (CR) rate was 36.6% (15/41) and 15.6% (5/32) respectively, and the difference was statistically significant (χ ²= 3.970, P= 0.046); the median progression-free survival (PFS) was 27 months and 24 months respectively, and the median overall survival (OS) was 35 months and 33 months respectively, and the differences were not statistically significant (all P > 0.05). Most adverse reactions occurred in grade 1-2, in which peripheral polyneuropathy and thrombocytopenia were the most common. Peripheral neuritis was the most common finding among the adverse reactions of grade 3. The incidence of adverse reactions in both groups was not statistically significant (P > 0.05). Conclusions VCD and VD regimen could be recommended as a better induction therapy for NDMM patients. Compared with VD scheme, VCD scheme has a higher CR rate.

Objective:To compare the effects of ultrasound-guided dynamic needle tip positioning (DNTP) and long axis in-plane (LAX-IP) techniques for axillary vein puncture and catheterization.Methods:One hundred Society of Anesthesiologists physical statusⅠ-Ⅲ patients of both sexes, aged 18-64 yr, with body mass index of 20-28 kg/m 2, scheduled for elective axillary vein cannulation, were divided into 2 groups ( n=49 each) using the random number table method: DNTP group and LAX-IP group.Axillary vein puncture was performed using DNTP technique and LAX-IP technique under ultrasound guidance in DNTP group and LAX-IP group, respectively.Successful puncture at first attempt, overall successful catheterization, the number of needle tip redirection, and axillary vein puncture time and catheterization time were recorded.The occurrence of complications such as axillary artery puncture, posterior wall penetration of axillary vein, hematoma formation, pneumothorax, and nerve injury was recorded. Results:Compared with group LAX-IP, the success rate of puncture at first attempt was significantly increased, the number of cases required needle redirection was decreased, and the puncture time was shortened ( P<0.05), and no significant change was found in the logarithm of the posterior wall penetration of axillary vein in group DNTP ( P>0.05). No complications such as arterial puncture, hematoma, pneumothorax, or nerve injury occurred in two groups. Conclusions:Compared with LAX-IP technique, ultrasound-guided DNTP technique can dynamically observe the position of the needle tip, the operation is simple and safe, and it is worthy of clinical promotion when used for axillary vein puncture and cannulation.