Objective To explore the relationship between EEG feature and TCD with secondary epileply in cerebrul infarction.Methods EEG and TCD were done and analyzed in 40 patients with secondary epileply in cerebrul infarction.Results The EEG abnormality rate was 95%,TCD abnormaity rate was 87.5%,abnormal EEG mainly showed increase of slow waves with low to middle amplitude,with diffuse or local distribution,epileptiform discharges were foumd only in 9 of the 38 ones,cerebral blood flow(CBF) was increased,decreased or bilateral dissymmetry,abnormal spectral frequency(higher force).Conclusion The abnormality rate of EEG is higher,but the detection rate of epileptiform discharges is lower;Unilateral increased of CBF might predict the side of epileptogenic focus.

Objective:To explore the effect of different nasal packing methods on the comfort of patients after operation.Methods:From January to August 2020, 216 patients with chronic sinusitis who were admitted to the Otolaryngology Head and Neck Surgery of Beijing Tongren Hospital by convenience sampling were selected as the research object. All patients underwent functional endoscopic sinus surgery under general anesthesia. According to the different nasal packing materials, the patients were divided into the nasopore packing group (132 cases) and the silicone drainage tube packing group (84 cases) . The patients were investigated with the Visual Analogue Scale (VAS) one day before operation and four hours after operation.Results:After functional endoscopic sinus surgery, the score of facial pain in the silicone drainage tube packing group was higher than that in the nasopore packing group, and the score for nasal congestion was lower than that in the nasopore packing group, with statistically significant differences ( P<0.05) . There were no significant differences in postoperative runny nose, hyposmia, headache, ear stuffiness and overall discomfort scores between the two groups ( P>0.05) . Conclusions:Attention should be paid to postoperative headache, hyposmia, and general discomfort in chronic sinusitis patients undergoing functional endoscopic sinus surgery and nasal packing. The head and face pain in patients with postoperative nasal packing with silicone drainage tube should be paid attention to, and the drainage tube should be kept unobstructed. Patients with nasopore packing should be focused on postoperative nasal congestion symptoms.

Objective:To construct a comprehensive nutritional index after treatment of nasopharyngeal carcinoma patients with intensity-modulated radiation therapy (IMRT), and to analyze its relationship with quality of life and 3-year survival period, and aimed to provide some reference for the management of nasopharyngeal carcinoma patients.Methods:This was a prospective cohort study. The clinical data of 431 nasopharyngeal carcinoma patients who admitted to Beijing Tongren Hospital Affiliated to Capital Medical University from January 2017 to December 2021 were collected using convenience sampling method. To evaluate the nutritional status of the patients, the BMI, change in body weight, hemoglobin, lymphocyte count, and albumin level and other clinical data of the patients were collected before and after intensity-modulated radiation therapy. The comprehensive nutrition index after IMRT was constructed by principal component analysis. The Chinese version of European Organization for Reasearch and Treatment of Cancer quality of life questionnare-Core 30 (EORTC QLQ-C30) and Quality of life questionnaire head and neck cancer module(QLQ-H&N35) were used to evaluate the patients′ quality of life. The best diagnostic cutoff point for predicting patient death within 3 years using ROC, and based on the determined optimal diagnostic cutoff point, all patients were divided into a low comprehensive nutritional index group and a high comprehensive nutritional index group. And analyzed the Pearson correlation between comprehensive nutritional index and quality of life.Differences in 3-year survival between the two groups were compared using the Kaplan-Meier method and Log-rank test.Results:Using the diagnostic threshold of receiver operating characteristic, all patients were divided into low comprehensive nutrition index group ( n=280) and high comprehensive nutrition index group ( n=151).The BMI, percentage of weight change, albumin, hemoglobin, and lymphocyte count of nasopharyngeal carcinoma patients before intensity-modulated radiation therapy were (23.14 ± 2.87) kg/m 2, (1.08 ± 0.14)%, (44.02 ± 4.52) g/L, (147.28 ± 15.57)g/L, (1.76 ± 0.56)×10 9/L, and higher than after intensity-modulated radiation therapy (21.14 ± 4.07) kg/m 2, (0.97 ± 0.16)%, ( 38.99 ± 5.12) g/L, (113.87 ± 18.24)g/L, (0.50 ± 0.18)×10 9/L, respectively, the difference were statistically significant ( t values were 8.34 to 44.47, all P<0.05).The comprehensive nutritional index constructed using principal component analysis was correlated with multiple dimensions of EORTC QLQ-C30) and QLQ-H&N35, with statistically significant differences ( r values were -0.169 - 0.245, all P<0.05). Kaplan-Meier curves indicated that the 3-year survival rate of the high comprehensive nutritional index group was higher than that of the low comprehensive nutritional index group, with 87.42% and 79.29% respectively, and the difference was statistically significant ( χ2=4.53, P<0.05). Conclusions:The constructed comprehensive nutritional index could reflect the comprehensive nutritional status of nasopharyngeal carcinoma patients. Nasopharyngeal carcinoma patients with a low comprehensive nutritional index score had a worse quality of life and shorter 3-year survival. Active intervention and improvement of malnutrition in nasopharyngeal carcinoma patients should be undertaken to improve patient quality of life and improve survival.

Objective To investigate the effects of postoperative semi-reclining position in early stage on the comfort degree of patients with endoscopic sinus surgery under general anesthesia. Methods Totally 106 cases of patients with endoscopic sinus surgery under general anesthesia were selected from the ENT&HN Surgery Department of Beijing Tongren Hospital during September 2014 to May 2015. The patients were randomly divided into the control group (n=54) and the experimental group (n=52). Patients in the control group adopted traditional clinostatism after surgery,while patients in the experimental group adopted early semi-reclining position after surgery. Four hours after surgery,patients' comfort degree with discomfort visual analogue score (VAS) were evaluated,and the incidence of neck-shoulder soreness and waist soreness of patients was compared between two groups. Results In the experimental group,the total discomfort VAS score of patients was 3.00 (2.00~5.00),which was lower than VAS score 4.00 (3.00~6.00) in the control group (Z=-2.270,P<0.05). In the experimental group,the incidence of shoulder-soreness was 0,and the incidence of waist soreness was 3.85%,and they were all lower than those in the control group (16.67%,11.11%) (χ2= 9.471,5.666;P<0.05). Conclusions Early semi-reclining position can effectively reduce the postoperative headache,ear fullness and general discomfort of patients with endoscopic sinus surgery,reduce the occurrence of shoulder-neck soreness and waist soreness of patients,and improve patients' comfort.

Objective To investigate the degree of pain, pain control and influencing factors of patients with silicone drainage tube after endoscopic sinus surgery, so as to provide the basis for the management of pain and comfort nursing. Methods From March to August in 2016, 102 patients undergone endoscopic sinus surgery were selected as the research objects. They were treated with silicone drainage tube within 48 h after operation. The patient's pain status and its influencing factors were assessed by the Brief Pain Scale (BPI) at 24 h and 48 h after operation. Results In 24-48 h after surgery, the most degree of pain, the lightest degree of pain, the average degree of pain, the exist degree and the overall degree of pain were significantly reduced than those in 24 h after surgery,and the differences were statistically significant (t=3.446, 4.790, 5.413, 4.758, 5.374;P<0.05); In 24-48 h after the surgery, the pain impact on daily life, mood, work, sleep and overall effects were significantly reduced than those in 24 h after the surgery, and the differences were statistically significant (t=2.729, 2.912, 3.260, 2.080, 2.702; P <0.05); 24-48 h after operation, the overall pain state of patients with patient-controlled analgesia (PCA) (2.15±1.69) was significantly lower than that patients who did not receive the PCA (3.26±1.94), and the difference was statistically significant (t=2.871, P=0.005). Conclusions The pain nursing of the patients with silicone tube should not be neglected, especially in 24 h after surgery nurses should strengthen the assessment and management of pain, and pay attention to the impact of pain; For pain control, we should not use single control mode, but should focus on exploring various ways to control pain.

To summarize the perioperative nursing of a patient with encephalomeningocele and hypopituitarism who had drug allergy after surgery. The defect location of skull base in this patient was exceptional, which led to the encephalomeningocele involving the seller region with hypopituitarism. The patient had a variety of complications after surgery, including cerebrospinal rhinorrhea and intracranial infection; the patient also had rare drug allergies such as hydroxyethyl starch solution and ceftriaxone delayed allergic reaction, which led to sacrococcygeal fixed drug eruption in patient. The focus of patient′s preoperative nursing work included computer-assisted preparation, psychological nursing, regulation and control of pituitary hypofunction;the postoperative nursing work focused on monitoring vital signs, observing brain symptoms, nursing sacral tail skin, and observing ocular symptoms. Through effective treatment and nursing, the patient recovered well, and was discharged 27 days after surgery.

Objective? To explore the mental state of laryngeal carcinoma patients after total laryngectomy and to analyze its correlations with coping style and social support. Methods? From January 2017 to October 2017, we selected 36 laryngeal carcinoma patients with total laryngectomy in otolaryngology dead and neck surgery at Beijing Tongren Hospital, Capital Medical University as subjects by convenience sampling. All of the patients were investigated with the Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), Medical Coping Modes Questionnaire (MCMQ) and Social Support Rating Scale (SSRS). A total of 36 questionnaires were sent out and 34 of them were collected. Results? Among 34 patients, the total scores of SAS and SDS were (45.38±10.27) and (50.32±11.82) respectively. The score of "avoidance" coping style of patients after total laryngectomy was higher than that of norm with a statistical difference (P＜ 0.05). Pearson correlation analysis showed that SAS and SDS were negatively correlated with the total score of social support (P＜0.05);SAS and SDS were positively correlated with the confrontation dimension of coping style (P＜0.05), and were negatively correlated with the avoidance dimension (P＜ 0.05). Conclusions? After total laryngectomy, patients are with high levela of anxiety and depression. Medical staff should guide patients to take correct coping styles after surgery to face diseases, and improve patients' social support to relieve patients' negative emotions and total laryngectomy,and to promote the rehabilitation of diseases.

Objective To explore the application of health education of keywords in the chronic sinusitis patients with functional endoscopic sinus surgery (FESS).Methods One hundred and eight chronic sinusitis patients with FESS from February 2012 to May 2012 were chosen and divided into the control group (n=56) and the observation group (n=52).The control group received the traditional health education , and the observation group received the health education of keywords on the basis of the control group .The awareness of health education knowledge and the nursing satisfaction of health education were compared between two groups .Results The scores of the awareness of health education knowledge 1 d before the operation , the day of the operation and 1 d after the operation were respectively (17.67 ±1.29), (14.94 ±1.35), (18.48 ±1.45) in the observation group , and were higher than those of the control group , and the differences were statistically significant (t=8.124, 10.741, 8.700, respectively;P<0.01).The score of the nursing satisfaction of health education in the patients was (3.40 ±0.53) in the observation group, and was (2.86 ±0.77) in the control group, and the difference was statistically significant (t=4.303, P<0.01).Conclusions The implementation of the health education of keywords can effectively improve the mastery of health education knowledge and the nursing satisfaction of health education in the chronic sinusitis patients with FESS , and increase the quality of nursing.

Objective To explore the effects of evidence-based nursing practice on reducing the incidence of pharyngo-cutancous fistula, shortening hospital day after surgery and easing the financial burden among laryngectomy patients.Methods From June 2017 to March 2018, we selected laryngectomy patients as subjects in Beijing Tongren Hospital. Patients were numbered according to the order being admitted to hospital and randomly divided into two groups with the random number table. Control group (n=51) received routine nursing. Experimental group (n=50) carried out routine nursing along with transforming evidence into nursing plan, implementing and evaluating nursing care effects by the Johns Hopkins nursing evidence-based practice (JHNEBP) model. We observed the incidence of pharyngo-cutancous fistula and hospital stay of patients between two groups.Results The incidence of pharyngeal fistula of experimental group and control group were 10.00 ％ and 27.45％ respectively with a significant difference (χ2=5.034,P=0.025). The hospital day of experimental group and control group were (12.78±3.99)d and (17.22±6.45)d respectively with a significant difference (t= -4.151,P<0.001).Conclusions The evidence-based nursing practice based on JHNEBP can reduce the incidence of pharyngo-cutancous fistula and shorten hospital day after surgery.

Objective:To explore the effects of continuous nursing on quality of life (QOL) in postoperative laryngeal cancer patients.Methods:The randomized controlled trial (RCT) on effects of continuous nursing on QOL in postoperative laryngeal cancer patients were retrieved in the Cochrane Library, Joanna Briggs Institute (JBI) Library, PubMed, EMbase, Web of Science, CINAHL, Sinomed, Chinese National Knowledge Infrastructure (CNKI) , WanFang data, VIP and ProQuest by computer from building database to October 2019. Two systematic review researchers independent evaluated the literature quality based on the "Australia JBI Critical Appraisal Tool (2016) ". RevMan 5.3 was used to data analysis.Results:A total of 8 RCTs were included. Meta-analysis showed that compared with routine nursing, continuous nursing improved the general health status of QOL among postoperative laryngeal cancer patients with a statistical difference in the merge effect [ SMD=2.59, 95% CI (1.70, 3.48) , Z=5.68, P<0.000 01]. Besides, continuous nursing also improved aspects of QOL, such as physical function, role function, emotional function and social function. Conclusions:The continuous nursing can improve the QOL of postoperative laryngeal cancer patients which is worthy of clinical application.