Objective:To summarize the nursing and treatment experience of patients with Chiari malformation type I (CMI) and syringomyelia (SM) complicated with central sleep apnea syndrome (CSAS) .Methods:A retrospective analysis was used to the clinical data of 23 patients with CMI and SM complicated with CSAS in the Department of Neurosurgery of Beijing Tiantan Hospital from January 2016 to December 2018. All patients underwent surgical treatment under general anesthesia, and were given preoperative and postoperative nursing care.Results:The clinical symptoms and manifestations of 23 CSAS patients improved after operation, and there were no adverse and serious postoperative complications. There were 5 severe CSAS patients who improved significantly at 3 months after surgery, reduced or stopped ventilator assistance according to their physical condition.Conclusions:Surgical treatment for CMI and SM complicated with CSAS is effective, fine and personalized preoperative and postoperative nursing care provides a guarantee for improving the success rate of patients' surgery and improving the prognosis.

Objective:To explore the effects of early wet compress with traditional Chinese medicine Ru-Yi-Jin-Huang-San on drug extravasation skin injury.Methods:Totally 21 patients with skin injuries caused by extravasation of different drugs from the First People's Hospital of Lianyungang and General Hospital of Eastern Theater Command between January 2017 and December 2019 were selected by convenient sampling. They received local wet compress with Ru-Yi-Jin-Huang-San according to the redness and swelling area, which was replaced once a day until the pain and swelling were ameliorated and the wound healed. Patients with irreversible tissue necrosis underwent debridement, anti-infection, negative pressure wound treatment or wet therapy according to the principles of wound care until the wound healed. The pain score, redness area, healing time and healing outcome were compared before and after wet compress, between upper and lower limbs, between wet compress within 24 hours and wet compress after 24 hours, and between patients with and without drug extravasation.Results:After wet compress with Ru-Yi-Jin-Huang-San for 2-13 days, the skin injury of 18 patients who received wet compress within 2-24 hours after extravasation healed completely, and the healing time was (6.44±2.99) d; 3 cases formed wounds, which healed after local debridement, anti-infection, wet therapy and negative pressure therapy, with a healing time of 67 (28, 154) d. There were statistically significant difference between the pain score before wet compress and those from day 1 to day 7 after wet compress ( P<0.05) ; there were statistically significant differences between the redness and swelling area before wet compress and those from day 1 to day 5 after wet compress ( P<0.05) ; there was no statistically significant difference in the redness and swelling area between day 6 and day 7 ( P>0.05) . There were no statistically significant differences in the pain score and the redness and swelling area between the upper and lower extremities before wet compress ( P>0.05) . 3 days after wet compress, the pain score of the upper extremities was lower than that of the lower extremities, and the difference was statistically significant ( P<0.05) , but there was no statistically significant difference in the redness and swelling area between the lower extremities and the upper extremities ( P>0.05) . Before wet compress, there was no statistically significant difference in the pain score and the redness and swelling area between the groups with different time of wet compress ( P>0.05) . 3 days after wet compress, the pain score of patients who received wet compress within 24 hours was lower than that of patients who received wet compress after 24 hours ( P>0.05) . The healing time of patients who received wet compress within 24 hours was shorter than that of patients who received wet compress after 24 hours, and the difference between the two groups was statistically significant ( P<0.05) . Before wet compress, there were no significant differences in pain score and the redness and swelling area between the groups with extravasation of different drugs ( P>0.05) . 3 days after wet compress, there were no statistically significant differences in the pain score and the redness and swelling area within the antibiotic extravasation group ( P>0.05) . Conclusions:Early wet compress with Ru-Yi-Jin-Huang-San is safe and effective for drug extravasation skin injury. The sooner the wet compress, the better the effect is.

Objective:To explore the role of one-to-one teaching led by international enterostomal therapist (ET) in the standardized training of wound stoma in gastrointestinal surgery.Methods:A total of 36 interns who underwent standardized training in the Gastrointestinal Surgery Department of The First Affiliated Hospital of Kangda College of Nanjing Medical University from July 2019 to January 2020 were selected as the control group, and the traditional teaching was adopted. Other 38 interns who were trained from May 2020 to October 2020 wre grouped into research group, and ET-led one-to-one teaching was adopted. The scores of theoretical knowledge and practical operation skills of gastrointestinal surgery wound stoma were compared between the two groups after the training, and the scores of case analysis, problem analysis and solving, knowledge application and comprehensive ability before and after the training were compared. Besides, satisfaction with methods and teaching effectiveness was compared. SPSS 25.0 was used for t test and chi-square test. Results:The clinical theoretical knowledge [(93.45±5.28) vs. (90.11±6.39)] and practical operation skills assessment scores [(92.25±6.18) vs. (89.13±5.36)] of the research group were all significantly higher than those of the control group after training ( P<0.05); the scores of case analysis ability, problem analysis and solving ability, knowledge application ability, and comprehensive ability of the two groups after the training were significantly higher than those before the training ( P<0.05), and the above scores in the research group were all higher than those in the control group ( P<0.05); the satisfaction of the interns in the study group with teaching methods and teaching effects was higher than that in the control group ( P<0.05). Conclusion:Applying ET-led one-to-one teaching to the wound and stoma teaching of gastrointestinal surgery residents can significantly improve their assessment performance, teaching satisfaction, and the teaching effect, and improve their case analysis ability, problem analysis and solving ability, knowledge application ability, and comprehensive ability.

This paper reviews several commonly used pressure injury (PI) risk assessment tools for children at home and abroad in recent years and the risk factors that affect the occurrence of PI in children, aiming to help clinical medical staff choose appropriate PI risk assessment tools and identify population with PI risk as soon as possible and effectively prevent the occurrence of PI.