Objective To investigate the evaluation value of magnetic resonance spectroscopy (MRS) combined with S-100B protein in the severity and prognosis in patients with acute subdural hematoma ( ASDH).Methods Eighty cases of ASDH patients and 20 cases of healthy check-up were selected.MRS was used to test NAA/Cr, Cho/Cr, NAA/Cho, and Glx /Cr in thalamus and corpus callosum.The blood S-100B protein was detected in 72 h after injury.The relationships of those MRS detection indices with glasgow coma scale ( GCS) and glasgow prognostic score ( GOS) for 2 months after injury were analyzed .Results MRS detection in-dex and the S100B protein in ASDH were compared between each group relative to normal control group , all difference had statistical significance ( P <0.05).As aggravating the severity of traumatic brain injury , Cho/Cr, Glx/Cr ratio, and S-100B protein concentra-tion were elevated , and NAA/Cho and NAA/Cr were reduced .All differences were statistically significant among poor recovery , good recovery, and normal control groups ( P <0.05).For patients with traumatic brain injury, there were worse prognosis, the higher ra-tios of Cho/Cr and Glx/Cr, higher concentration of S-100B protein, and lower ratios of NAA/Cho and of NAA/Cr.GCS score and GOS scores were negatively correlated with Cho/Cr and Glx/Cr ratios of corpus callosum , and were positively correlated with NAA/Cho, NAA/Cr ratios of corpus callosum .S-100B protein was positively correlated with Cho/Cr and Glx/Cr, and was negatively correlated with NAA/Cho and NAA/Cr.MRS combined S-100B can improve the prognosis of patients with up to the accuracy of 81%.Conclu-sions MRS detection in the early stage after injury of ASDH patients has important value in assessment of the severity of the injury and its prognosis , the accuracy of assessment of prognosis is improved with a combination of MRS detection and blood S -100 B protein meas-urement.

Objective:To analyze the development and research focus of dental hygienist in recent 10 years so as to provide a reference for related studies in China.Methods:From 1st January 2009 to 2ed December 2019, dental hygienist related literatures were retrieved in Web of Science Core Collection. Bibliometrics was used to analyze the annual number, research directions, research types, message dispatch of country and institution, authors, publications, funding agencies and citation frequency of the literature.Results:A total of 778 articles were included. Number of literatures was on the rise; research direction focused on oral surgery, public environmental occupational health and health care service and so on; literature types were mainly on journal articles and review articles; the journal with the most published articles was the International Journal of Dental Hygiene; capital contribution of United States Department of Health and Human Services was the largest. Conclusions:With the increase of global dental hygienist, more and more countries and areas pay attention to the cultivation of dental hygienist. Advanced countries such as Europe and America, continuously expand the scope of work, perfect the educational system, improve the ability of treatment intervention toward interdisciplinary cooperation development. At present, our country is still in the academic research and exploration stage of dental hygienist needing to increase the attention of research focus of dental hygienist. We should learn the development experience of dental hygienist in advanced countries and build the dental hygienist system suitable for our country.

Objective To explore the value of neuroendoscopy combined with Endport for the surgery of hypertensive intracerebral hemorrhage.Methods We retrospectively analyzed 92 cases of hypertensive intracerebral hemorrhage in our department from January 2016 to February 2018.According to the different surgical methods,they were divided into small bone window group and neuroendoscopic group,47 cases in small bone window group and 45 cases in neuroendoscope group.The amount of intraoperative bleeding,operative time,postoperative hematoma clearance,postoperative rebleeding,hospitalization time,postoperative complications and Glasgow prognosis expansion score (GOS-E) were recorded for statistical analysis.Results Compared with neuroendoscopy group,small bone window group had more bleeding loss [(182.6 ± 34.5) ml vs (103.3 ± 25.7) ml] and longer operation time [(168.7 ± 26.3) min vs (115.7 ± 18.7)min],with significant statistically difference (P ＜ 0.05).The hematoma clearance rate (90.3 ± 5.3) ％ in the small bone window group,was lower than that in the neuroendoscopic group (92.8 ± 6.8) ％,but with no statistical significance (P ＞ 0.05);Postoperative rebleeding occured in 3 cases (6.4％) in small bone window group and 2 cases (4.4％) in the neuroendoscopic group,with no statistically significant difference between the two groups (P ＞ 0.05).Compared with neuroendoscopy group,small bone window group had longer hospitalization time [(18.5 ± 4.3) days vs (13.5 ± 3.8) days],higher tracheotomy rate [15 (31.9％) vs 8 (17.8％)],with significant statistically difference (P ＜ 0.05).The number of patients with GOS-E score ＞ 4 in small bone window group 2 months after operation was less than that in neuroendoscopy group [42.6％ (20/47) vs 62.2％ (28/45)],with significant statistically difference (P ＜ 0.05).Conclusions Endoscopic treatment of intracerebral hemorrhage has the advantages of minimally invasive,short operation time,less intraoperative hemorrhage,low incidence of complications and fast recovery of postoperative function.

Introducing the continuing education of the dental hygienist in eight states of the U.S.,to understand the the category of practice,professional ability,curriculum, teaching methods and teaching evaluation standard. To analyze the continuing education in eight states to provide a reference for constructing a curriculum system that is suitable for China.

Objective: To analyze the clinical value of SPECT/CT in diagnosis of skull base bone invasion and clinical decision-making for nasopharyngeal carcinoma (NPC), and to compare their diagnostic value with SPECT/CT, CT, MRI, and MRI combined with SPECT (MRI-SPECT) for skull base bone invasion. Methods: Before treatment, among 348 newly diagnosed NPC patients, CT scan was performed in 186 patients (group A) and the remaining 162 patients received MRI scan (group B). Clinical doctors then made clinical management decisions according to the CT or MRI results. After that, all patients underwent ⁹⁹Tc^m-MDP SPECT/CT examination for nasopharyngeal local tomography, and the results were provided to the clinical doctors to make clinical management decisions again. The changes between the two clinical management decisions were scored according to diagnosis, range of lesion, staging, treatment regimens, and auxiliary examination. The diagnostic value of CT scan, MRI scan, SPECT/CT and MRI-SPECT for skull base bone invasion was then evaluated and compared. Results: In terms of changes in scores of clinical management decisions, the score of group A was 1.387 and group B was 0.951, showing a significant difference between the two groups by Wilcoxon test (Z=6.570, P<0.001). By χ² test, there were correlations between CT and SPECT/CT (χ² =98.495, P<0.001), and between MRI and SPECT/CT (χ² =32.662, P<0.001). The consistency of CT and SPECT/CT (Kappa=0.713) was greater than MRI and SPECT (Kappa=0.449). The sensitivity of CT, MRI, SPECT/CT and MRI-SPECT was 67.1%, 84.5%, 90.8% and 100%, the specificity was 73.3%, 92.3%, 85.6% and 84.6%, and the area under the ROC curve was 0.702, 0.884, 0.882 and 0.923, respectively. Conclusions SPECT/CT has important impact on clinical management decision for NPC. In the judgement of skull base invasion, the diagnostic value of SPECT/CT is significantly higher than CT and approximately equal to MRI. SPECT/CT should be one of the routine examination methods of nasopharyngeal carcinoma. In addition, in view of its greater diagnostic value, MRI combined with SPECT should be the focus of future imaging studies.

Objective:To explore the knowledge of pediatric nurses about intravenous infusion therapy, find the problems, and provide a reference for managers to provide targeted training.Methods:In this multicenter cross-sectional study, the nurses on duty were selected from 43 hospitals under the medical alliance of Beijing Children's Hospital by convenient sampling from July 24th to 31st, 2018. The self-made questionnaires were used in this study, and data were collected online through wjx.cn. The questionnaires were developed by 4 veteran venous infusion therapists according to the Infusion Therapy Standards of Practice (2016 ) as well as the Technical Standards for Intravenous Therapy Nursing Issued by the National Health Commission of the People's Republic of China in 2014. The questionnaire mainly included three parts. Part I was the basic information of the respondent subjects and hospitals; Part II was the knowledge of the subjects about domestic standards for infusion therapy and Infusion Therapy Standards of Practice; and Part III the knowledge of the subjects about infusion therapy operations and maintenance as well as the current status of infusion therapy in their departments. SPSS 17.0 was used for statistical analysis. Results:A total of 8 405 pediatric nurses were investigated in this study. The average knowledge of infusion therapy was (11.72±2.41), and the pass rate was 54.8%. The survey showed that nurses performed well in selecting infusion tools and puncture sites according to the nature of the drug, evaluating the patient and treatment plan before infusion therapy, the sealing method of peripheral vein indwelling needles, and treatment methods when resistance was encountered or no blood was returned in suction. The univariate analysis revealed that the level of the hospital, whether the hospital had a dosing center and an infusion therapy group, the nurse's education, job title, working years, position, and whether to teach young nurses were the main influencing factors to nurses' knowledge about infusion therapy ( P<0.05) . The results of Logistic regression analysis showed that whether the hospital had a dosing center and a infusion therapy group, and the nurse's education background, title, working years, position, and teaching were the main influencing factors for the nurse's knowledge of infusion therapy ( P<0.05) . Conclusions:Pediatric nurses have insufficient knowledge about infusion therapy. They need to be further trained in the basics of infusion therapy, especially in the correct use of infusion tools, the proper selection of puncture sites, and catheter maintenance.

European dental hygienists federation defines dental hygienists as the main providers of preventive oral care (including primary, secondary and tertiary prevention) , which is committed to promoting and improving the oral health of individuals, families and the public. This article mainly introduces the development status, professional competence requirements, work content, education system and qualification certification methods of dental hygienists in European countries so as to provide references for the allocation of dental assistants and nursing standardized development of Department of Stomatology in China and improve the nursing quality of Department of Stomatology.

BACKGROUND:The stability of the pelvis is mainly determined by the posterior pelvic ring and the sacroiliac joint.The posterior pelvic ring injury and the dislocation of the sacroiliac joint caused by high energy impacts such as car accidents increase year by year.Surgical treatment is the best method,and there are many kinds of endophytorepair methods in clinical practice,but which treatment method has the best biomechanical properties is still controversial. OBJECTIVE:To compare the biomechanical properties of three kinds of internal implants:anterior double plates,posterior bridging plate and tension nail in the repair of unilateral unstable pelvic posterior ring injury,to provide a reference for the clinical treatment and development of a new pelvic tension screw. METHODS:(1)Finite element simulation:Mimics,Wrap and SolidWorks were used to establish normal pelvic model,unilateral injured pelvis model,and three kinds of internal implant repaired models(anterior double plates,posterior bridging plate and tension nail).Ansys was used to analyze the stress and deformation of the models.(2)Biomechanical test:A total of 15 intact pelvic specimens were randomly grouped into five groups,normal pelvic model,unilateral injured pelvis model,anterior double plates,posterior bridging plate and tension nail groups.The mechanical test was performed using an Instron E10000 testing machine. RESULTS AND CONCLUSION:(1)Simulation:In the normal pelvic model,the average displacement of the sacrum was 0.174 mm,and the maximum stress of the sacral iliac bone was 10.51 MPa,and the stress distribution was uniform.The mean sacral displacement of the unilateral injured pelvis model was 0.267 mm,and the stress concentration of the model was obvious.The mean displacement of the sacrum in the three repaired models was close to that in the normal pelvic model,and the stress distribution of the sacral iliac bone in the tension nail repaired model was uniform.(2)Mechanical test:The stiffness of the normal pelvic model was(226.38±4.18)N/mm,and that of the unilateral unstable pelvic model was the smallest(130.02±2.19)N/mm.The deviation of the normal pelvic model stiffness and the three repaired models'stiffness were all within(±10%),and the repair effect was obvious.(3)The simulation results were in agreement with the experimental results.(4)The biomechanics of the tension nail repaired model was the most similar to that of the normal pelvis,and this method was the best.The repairing stiffness of the anterior double plate was too large,and the stress shielding effect was more significant.The posterior bridging plate repair could not solve the compensatory effect of the normal side soft tissue and had defects.This study provides an optimal basis for clinical surgery.(5)The new type of pelvic tension nail should be improved from the point of view of the tension nail to retain the good biomechanical properties of the tension nail,while adding other advantages,such as being used for the osteoporotic pelvis.