Objective The purpose of this study was to observe the recovery effects of nursing intervention on foot-drop complicated after surgical trauma of bone fracture, and to discuss effective nursing strategies and measures. Methods 60 cases of patients with foot-drop complicated after internal fixation of tibial fractures were randomly divided into the observation group and the control group with 30 cases in each group, the observation group used lower limb joints rehabilitation trainers for ankle passive motion, the control group used artificial methods for ankle passive motion. Ankle movement and muscle strength recovery was observed and recorded after 12 weeks in two groups. Results Ankle joint mobility and muscle strength was significantly better in the observation group than in the control group. Conclusions Using lower limb joints rehabilitation trainers for ankle passive motion showed better effect than artificial methods for ankle passive motion.

Objective To observe the 3 years or more effects on optical correction,refraction,and orthokeratology with rigid gas permeable contact lens(RGPCL) wearing in patients with keratoconus.Design Retrospective case series.Participant 73 keratoconus patients(136 eyes) fitted with RGPCL.Methods Patients wearing RGPCL for 3 years or more in Peking University Optometry & Ophthalmology Center were observed.Correct visual acuity was determined before and at 1,2 and 3 years of lens wearing,and the refractive power,corneal curvature,corneal astigmatism and corneal morphological changes were measured with auto-refractomer/keratometer and keratoconus screening analysis system of computer-assisted corneal topography at the same time.The changes of base curve and RGPCL power were also compared.All patients were divided into mild keratoconus group(Group A),moderate and severe keratoconus group (Group B).Main Outcome Measures Visual acuity,refractive power,base curve of RGPCL,corneal topography parameters.Results The patients wore RGPCL for 49.3?15.3 months(36-76 months).At the initial visit,uncorrected visual acuity(UVA) was 3.76?0.45, corrected visual acuity with spectacles(SPVA) was 4.57?0.53,and with RGPCL(RGPVA) was 4.89?0.14.RGPVA was improved significantly (F=171.994,P=0.000).RGPVA at last visit(4.95?0.11) was better than that at initial visit(t=-6.733,P=0.000),which was more significant in group B than that in group A.The rate for RGPVA more than 0.8 at the initial,1 year,2 years and 3 years of lens wearing was 85.13%,86.76%,85.60%and 84.62%respectively.At the initial visit and last visit,the myopia diopters and the corneal astigmatism were 7.13?4.01D vs.6.23?3.42D(P=0.014) and 6.23?3.24D vs.4.42?2.34D(P=0.000) respectively.The RGPCL base curve and lens power were 7.38?0.50 mm vs.7.54?0.42 mm(P=0.000),and -6.22?3.59 D vs.-5.33?3.09 D(P=0.000) respectively. The changes of power and base curve of lens in group B were more significant than that in group A.The decrease of 9 corneal topography parameters between initial visit and last visit was significant statistically(all P

Objectives To explore the effect of traditional Chinese medicine wine combired with electromagnetic therapy for the neck,shoulder,back and leg pain. Methods Eighty cases of patients with neck,shoulder,back and leg pain were randomly divided into 2 groups,with 40 cases in each group,treatment group was given the traditional Chinese medicine wine and electromagnetic therapy,the control group was prescribed(only with electromagnetic therapy),use the numerical rating scale to observe the effects of two groups before therapy,3 days and 7 days after therapy . Result After treatment,the pain of the treatment group was relieved significantly better than that of the control group(P<0.05). Conclusion Traditional Chinese medicine wine combired with electromagnetic therapy for the neck,shoulder,back and leg pain has satisfactory effect,and is worthy to promotion.

Objective: To understand the awareness of palliative care and its influencing factors in community residents in Hangzhou,so as to provide basis for the development of palliative care service. Methods: By convenient sampling method,the residents in the urban-rural junction of Xihu District were recruited. A self-designed questionnaire was used to investigate their awareness of palliative care. The logistic regression model was employed to analyze the influencing factors. Results : A total of 519 questionnaires were recovered,with a response rate of 97.92%. There were 227 males and 292 females,accounting for 43.74% and 56.26%,respectively. There were 43,218 and 258 residents with more,basic and little understanding about palliative care, accounting for 8.29%,42.00% and 49.71%. The residents learned about palliative care mainly through television and radio,with 245 cases accounting for 47.21%;and they thought that the main reason for low awareness of palliative care was a lack of related knowledge,with 396 cases accounting for 76.30%. The results of multivariate logistic regression analysis showed that 50-59 years old（OR = 0.467,95% CI：0.285-0.767）,primary school education and below（OR = 2.248,95%CI：1.239-4.079）and experience of caring for dying patients（OR = 1.551,95% CI：1.094-2.199）were the influencing factors for the awareness of palliative care. Conclusion The residents in Hangzhou had relatively low awareness of palliative care,which were associated with age,education level and experience of caring for dying patients.

A total of 105 undergraduate students of the class 2014 majoring in clinical medicine in Sun Yat-Sen University received probation teaching in our department from October 2017 to May 2018,according to the syllabus of dermatology and venereology of clinical medicine.Senior teachers in our department were responsible for probation teaching,with the help of the independent wards in our department and probation teaching at the outpatient service.The teachers recorded the whole teaching process and evaluated the students' memory after probation.Through the teaching in wards and at the outpatient service,the students mastered the requirements in the syllabus of dermatology and venereology and achieved good results.

Objective To investigate the factors of term pregnancy fetal distress at term pregnancy and intervention midwifery cesarean section and vaginal fetal distress. Methods All 104 cases of full-term pregnancy with maternal fetal distress in labor were random divided into observation group and control group from our hospital from October 2012-October 2013, each group had 52 cases. Mothers in the control group were given vaginal midwifery, maternal in the observation group were used cesarean section, fetal distress factors and maternal and neonatal outcomes of two groups were compared and analyzed. Results Fetal distress factor (placenta, umbilical cord factors, maternal factors, fetal factors or amniotic fluid, etc.) of two groups were compared, the difference was not statistically significant (P>0.05). The inci dence of postpartum hemorrhage, neonatal asphyxia, hypoxic ischemic encephalopathy, fetal growth restric-tion,puerperal infection and hypoproteinemia of the observation group were 5.77%,5.77%, 3.85%,1.92%, 11.54%,9.62%,compared with 9.62%, 7.69%, 5.77%, 1.92%, 7.69%, 5.77%in the control group,the difference was not statis-tically significant (P>0.05). Single factor factors Logistic regression analysis results showed that the umbilical cord and placenta, fetal and maternal,amniotic fluid dung are independent risk factors of fetal distress. Multiple factors Logistic regression analysis results showed that fetal and maternal,amniotic fluid dung are independent risk factors of fetal dis-tress. neonatal deaths of two groups did not occur. Conclusion Vaginal delivery applications and cesarean surgery in treatment of fetal distress of full-term pregnancy can get better maternal and neonatal outcomes, should be based on the specific circumstances of women to choose the appropriate mode of delivery.

Taking the course's characteristics and advantages into account, this study explores the systematic implementation of standardized teaching rounds in the clinical probation sessions of the Dermatology and Venereology course , and evaluates its effect by analyzing the cases of 125 medical students from grade 2015 of Sun Yat-sen University . The results showed that the implementation of standardized teaching rounds has positive effect on the course.

Clinical final examination is an important link in the standardized training of residents in dermatology and quantification of evaluation indicators is one of the important parameters. In this study, the scores of clinical examinations of six candidates who participated in standardized training of residents in dermatology of Sun Yat-Sen University in June 2019 were taken as examples to explore the quantitative indicators of standardized and multi-station clinical final examinations. The indicators contained four stations and five links: skin pathological reading, skin biopsy, medical history collection and physical examination, medical record writing, and comprehensive questioning, which covered the main contents of the standardized training outline of residents in dermatology. Each evaluation indicator was refined and quantified. Finally, heuristic ideas were put forward, including a wider range of standardized and multi-station clinical examinations, introduction of new examination places, and utilization of information technology.

Objective:To investigate the value of CT tumor-thyroid marginal contact range (MCR) for predicting capsular invasion and cervical lymph node metastasis in papillary thyroid carcinoma (PTC) with a diameter>1.0 cm and papillary thyroid microcarcinomas (PTMC) with a diameter ≤ 1.0 cm, and to evaluate the diagnostic efficacy of direct CT signs for lymph node metastasis.Methods:The CT data of 148 patients with PTC (>1.0 cm) and 193 patients with PTMC confirmed by surgery and pathology were retrospectively analyzed from January 2017 to April 2020 at Hangzhou First People′s Hospital. MCR was evaluated based on CT images and classified as<1/4 tumor circumference or ≥1/4 tumor circumference. Direct CT signs of cervical lymph nodes were observed, including cystic change, microcalcification, hyperenhancement, short/long diameter≥0.5, clustered lymph nodes or central area turbidity. The difference in the distribution of MCR between PTC (>1.0 cm) and PTMC was compared using the χ 2 test, and the efficiency of MCR and direct CT signs for diagnosing capsular invasion and lymph node metastasis was calculated using the pathological results as the gold standard. Results:In 148 PTC (>1.0 cm) and 193 PTMC patients, the pathological results showed capsular invasion in 88.5% (131/148) and 57.0% (110/193), and lymph node metastasis in 71.6% (106/148) and 44.0% (85/193), respectively. In PTC (>1.0 cm) patients, MCR≥1/4 tumor circumference was more common in patients with capsular invasion (χ2=22.211, P<0.001) and lymph node metastasis (χ2=4.746, P=0.029), and the corresponding sensitivity and specificity for predicting capsular invasion and lymph node metastasis were 84.7% (111/131) and 64.7% (11/17), 83.0% (88/106) and 33.3% (14/42), respectively. In PTMC patients, MCR≥1/4 tumor circumference was more common in patients with capsular invasion (χ2=66.066, P<0.001) and lymph node metastasis (χ2=5.343, P=0.021), and its sensitivity and specificity for predicting capsular invasion and lymph node metastasis were 87.3% (96/110) and 69.9% (58/83), 71.8% (61/85) and 44.4% (48/108), respectively. The sensitivity and specificity of direct CT signs for diagnosing lymph node metastasis in PTC (>1.0 cm) and PTMC were 89.6% and 73.8%, 69.4% and 76.9%, respectively. Conclusions:Both direct CT signs and MCR ≥ 1/4 tumor circumference can predict cervical lymph node metastasis in PTC patients, and the former had higher sensitivity and specificity. MCR≥1/4 tumor circumference has high efficiency for predicting capsular invasion in PTC patients.