Objective To analyze the subjective and objective results and the correlation of nasal obstruction because of nasal structural variation pre and post operation,and to provide clinical evidence for surgery and curative effect.Methods Three groups were included in this study:group 1 were 78 patients with structural rhinitis,group 2 were 72 patients with chronic sinusitis (without nasal polyp) and group 3 were healthy controls of 75 cases.Assessment of nasal obstruction was achieved by visual analog scale (VAS),and objective measurement was achieved by rhinomanometry and acoustic rhinometry.The first two minimum cross-sectional area of nasal cavity (MCA1,MCA2),their distances from the nostrils (MD1,MD2) and the nasal volume of 5 cm depth from the nostril (NV5) were recorded.The ratio of the parameters of the two sides of the nasal cavity was calculated respectively.Nasal resistance total (RT) and calculated right-left nasal resistance ratio (Rlr) were recorded.Patients of group 1 and group 2 accepted endoscopic surgery and received the above evaluation again at three months after surgery.Three groups were compared with statistical test.Results The preoperative values of three groups (MCA1,MD1,MCA2,MD2,NV5,RT) showed no statistical significance (F value was 0.945,0.245,1.380,0.036,0.866,1.651,respectively;all P ＞ 0.05),while their ratio had statistical differences except MD1 (F value was 5.242,1.726,4.882,4.005,5.066,5.316;P =0.013,0.199,0.019,0.024,0.018,0.011,respectively).Statistical results between the ratio of values (MCA1,MD1,MCA2,MD2,NV5,RT) and VAS of nasal obstruction of group 1 and group 2 showed significant positive correlations pre operation (r of group 1 value was 0.471,0.418,0.260,0.324,0.305,0.459,respectively;r of group 2 value was 0.373,0.403,0.288,0.366,0.402,0.249,respectively;all P ＜ 0.05).VAS scores pre and post operation of group 1 had statistically difference (t =35.122,P ＜0.05).Postoperative value of MD1,MD2 and RT among three groups had no statistical difference (F value was 0.178,0.582,0.905,respectively;all P ＞ 0.05).Postoperative value of MCA1,MCA2,NV5 among three groups had statistical difference (F value was 4.010,5.126,4.901,respectively;all P ＜ 0.05).Postoperative ratio of MCA1,MD1,NV5 and Rlr among three groups had no statistical difference (F value was 1.023,0.944,0.524,0.996,respectively;all P ＞ 0.05).Postoperative ratio of MCA2 and MD2 among three groups had statistical difference (F value was 4.859,4.357,respectively;all P ＜ 0.05).Conclusion Severity of nasal obstruction is related to structural variation of nasal cavity and the purpose of surgery is to restore structural symmetry of bilateral nasal cavity.

Objective:To understand the current situation of care needs for disabled elderly people, analyze the impact of the family environment and community services on the care needs and care pathways of older people with disabilities and to formulate effective interventions.Methods:A cross-sectional survey was conducted from August 2022 to March 2023 in five tertiary-level hospitals in Tangshan city. The survey included 332 elderly people who were disabled before hospitalization and their primary caregivers, who were selected using a convenience sampling method. The survey investigated their general information, degree of disability, family members′ support, children′s filial piety and old age ethical level, family relationships, and the care needs of the elderly people who were disabled. SPSS 22.0 was used for one-way and correlation analyses as well as multiple linear regression analyses, and AMOS 22.0 was used for the development of structural equations for path analysis.Results:Among 332 disabled elderly individuals, there were 166 males and 166 females each. The care needs score for elderly people with disabilities was 101.54 ± 16.38. The care needs of this population can be influenced by several factors, including the level of disability, number of chronic conditions, presence of chronic pain, filial piety and old age ethical level of caregivers, family relationships, and the availability of care services in the community or village. These factors had direct effects of 0.468, 0.155, -0.083, -0.350, -0.094, and 0.104, respectively.Chronic diseases and chronic pain indirectly affected the demand for care through the degree of incapacity (with respective indirect effect values of 0.065 and 0.049). Additionally, the demand for care was indirectly influenced by the level of filial piety and ethics of the caregiver through the degree of incapacity and the family relationships (an indirect effect value of -0.162).Conclusions:The care needs of the disabled elderly are high, and the personal physiology, family environment and community support of the disabled elderly will directly or indirectly affect their care needs. Therefore, many factors should be considered comprehensively considered to improve the quality of care of the disabled elderly.

Objective:To evaluate the arousal effect of plantar reflex area and acupoint massage combined with music therapy in patients with brain trauma and coma.Methods:From March 2022 to March 2023, 90 patients with brain trauma and coma who were treated in the Neurosurgery Intensive Care Unit of Tangshan Gongren Hospital in Hebei Province were selected as the research subject. According to the random number table method, patients were divided into a control group, experimental group 1, and experimental group 2, with 30 cases in each group. The control group received routine nursing for brain trauma, while the experimental group 1 received music therapy with the natural voice on the basis of the control group. The experimental group 2 was treated with plantar reflex area and acupoint massage treatment on the basis of the experimental group 1. This study compared the Glasgow Coma Scale (GCS) scores and Coma Recovery Scale-Revised (CRS-R) scores of three groups of patients before and after intervention.Results:After 2, 4, and 6 weeks of intervention, the GCS scores and CRS-R scores of patients in experimental group 2 were higher than those in the control group and experimental group 1, with statistically significant differences ( P<0.05) . Conclusions:The combination of plantar reflex area and acupoint massage with music therapy has a certain arousal effect on patients with brain trauma and coma, and can be promoted and applied in clinical practice.

OBJECTIVETo compare the efficacy difference between's flying acupuncture combined with conventional treatment and conventional treatment alone on acute cerebral infarction hemiplegia.

METHODSA total of 120 patients were randomly divided into an observation group and a control group, 60 cases in each one. The control group was treated with conventional treatment, including anti-platelet aggregation, lipid-lowering, formula of traditional Chinese medicine which could promote circulation and remove stasis, neurotrophic medication and symptomatic treatment; mannitol was used for cerebral infarction with large area or increased intracranial pressure. Based on the conventional treatment applied in the control group, the observation group was treated with flying acupuncture at the affected Jianyu (LI 15), Quchi (LI 11), Shousanli (LI 10), Waiguan (TE 5), Hegu (LI 4), Huantiao (GB 30), Biguan (ST 31), Futu (ST 32), Zusanli (ST 36), etc. The treatment was given once a day, six days per week, for totally 2 weeks. The simplified Fugl-Meyer score, National Institute of Health Stroke Scale (NIHSS) and ADL-Bathel index (BI) score were evaluated before and after treatment in the two groups.

RESULTSAfter the treatment, the simplified Fugl-Meyer and BI were significantly increased in both groups (all<0.05), which was significantly higher in the observation group (both<0.05); after the treatment, the NIHSS was significantly lowered in both groups (both<0.05), which was significantly lower in the observation group (<0.05).

CONCLUSION 's flying acupuncture combined with conventional treatment were effective for acute cerebral infarction hemiplegia, which have better efficacy than conventional treatment on improving motor function, neurological deficit and daily living ability, and the pain is mild.