Objective To explore the best methods of catheterization in patients with neurogenic bladder using clean intermittent self-catheterization. Methods From December, 2014 to December, 2015, sixty patients with neurogenic bladder were equally divided into observation group who were taught the non-contact clean intermittent self-catheterization, and control group who were taught routine clean intermittent self-catheterization. Their materials, times to learn, and the incidence of catheter contamination and urinary tract infection were compared. Results The observation group mastered the catheterization in fewer times of learning than the control group (Z=-4.400, P<0.001). The incidence of catheter contamination (χ2=5.880, P=0.015) and urinary tract infection (χ2=4.043, P=0.044) were less in the observa-tion group than in the control group. Conclusion Non-contact clean intermittent catheterization is beneficial to manage neurogenic bladder.

OBJECTIVE: The purpose of the study was to investigate the balance function of the patients with benign paroxysmal positional vertigo (BPPV) during standing. METHOD: In this study 41 patients with posterior semicircular canal BPPV (PC BPPV) and 11 patients with horizontal semicircular canal BPPV (HC BPPV) were recruited. Dynamic balance during standing was measured in Sensory Organization Test (SOT). Static balance during standing was measured in modified Clinical Test of Sensory Interaction and Balance (mCTSIB). Data of BPPV patients were compared to that from 44 normal controls. RESULT: Scores of the patients with PC BPPV were lower than that of the normal controls in the last three test conditions of SOT. Patients with PC BPPV demonstrated greater sway velocity in stance on foam with eyes open and eyes closed in mCTSIB. No postural deficit was observed in neither SOT nor mCTSIB when the patients with HC BPPV were compared to the normal controls. CONCLUSION Disorders of the horizontal semicircular canal do not influence postural control. Both dynamic and static posturography can detect the postural imbalance caused by posterior semicircular canal dysfunction.
Benign Paroxysmal Positional Vertigo ; physiopathology ; Case-Control Studies ; Humans ; Postural Balance ; Semicircular Canals ; physiopathology

Objective To explore the influencing of continuous quality improvement on fall prevention of hospitalized patients in Department of Ophthalmology. Methods It was established fall program team of continuous quality improvement, in order to focus specialty, bring into knowledge-attitude-behavior model so as to improve cognition of medical staff and patients, coordinate and cooperate, carry out predictive and targeted nursing according to evaluate, inform, prevent, rescue and improve safety management procedure. The fall incidence and nursing quality were compared in inpatients between before ( 2011 to 2012 ) and after ( January 2013 to June 2014 ) continuous quality improvement. Results Before improvement, the fall incidence in inpatients was 0. 27% ( 7∕2 569 ) and dropped to 0 after improvement (χ2 = 6. 50, P < 0. 05 ); after improvement, nurse educated rate and executed rate were 100% and 97. 52%; patient′s awareness rate, executed rate and satisfaction rate were 91. 98%, 90. 01% and 98. 49% better than those before improvement (χ2 =224. 67,78. 09,58. 37,256. 70,135. 56;P<0. 01). Conclusions Nursing procedure is used to develop nursing quality continuous improvement, enhance safety awareness, improve cognition and behavior, so as to effectively prevent hospitalized patients to fall down in Department of Ophthalmology, enhance nursing quality, patient′s safety and satisfaction.

Objective:To investigate the effect of chimeric flap pedicled with superficial branch of superficial iliac circumflex artery in repair of soft tissue defect of dorsal hand combined with metacarpal bone defect.Methods:From May 2015 to January 2022, 34 patients(28 males and 6 females) of soft tissue defects of dorsal hand with metacarpal bone defects were treated in the Department of Orthopedics of Yibin Third People's Hospital. The age of patients ranged from 22 to 51 years old, with an average age of 37 years old. The areas of soft tissue defects after debridement were 2.5 cm×5.0 cm-4.5 cm×9.0 cm, and the defects were all in dorsal hand and dorsal wrist. The lengths of metacarpal bone defect were 1.8-4.1 cm. All the patients had only single metacarpal bone defect, among which: 14 patients had defects in first metacarpal bone, 7 in second metacarpal bone, 4 in third metacarpal bone, 8 in fourth metacarpal bone and 1 in fifth metacarpal bone. All the patients were repaired by chimeric flap pedicled with superficial branch of superficial iliac circumflex artery. The size of flaps were 3.6 cm×5.4 cm-5.2 cm×9.5 cm. Anticoagulation, thermal preservation and plaster fixation were applied for 4-6 weeks after surgery. Postoperative follow-ups included regularly outpatient clinic visit, telephone or Wechat reviews. Follow-up items covered: the feeling and appearance of flaps in recipient sites, healing of the donor sites and recovery of hand functions.Results:All the 34 chimeric flaps survived. Regular follow-up lasted for 3 to 15(average, 10) months. All incisions in the donor sites of hip healed in stage I. TPD of the flaps was 5.1-7.3(mean, 6.4) mm. Appearance of flaps in the receiving area were satisfactory without swelling. Movement of wrists and metacarpophalangeal joints met the basic requirement of movement. The healing time of metacarpal defect was 2-3 months with an average of 2.8 months. Hand functions were evaluated at excellent in 6 patients and good in 28, according to the Evaluation Standard of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association.Conclusion:The chimeric flap pedicled with superficial branch of superficial iliac circumflex artery is an ideal flap to repair the soft tissue defect in dorsal hand combined with metacarpal bone defect. It has advantages of less donor site damage, good blood supply of flap, simple surgical procedure, and one-stage repair of a combined soft tissue and metacarpal bone defects.

Objective To explore the implementation effects and application value of the Clinical Rehabilitation Integration Plan based on the graded management of rehabilitation treatment programs in a 3A general hospital.Methods The details of the programme were firstly formulated according to the needs of clinical rehabilitation and the implementation plan was formed,and then the integrated clinical rehabilitation work was carried out for 1 year accordingly,and finally the effects before and after the implementation of the programme were compared and analysed by selecting the indicators of departmental operation and patient satisfaction.Results The rehabilitation programme was classified into 4 levels according to the degree of technical difficulty and medical risk,and its connotation and management requirements were defined in detail.The implementation of the programme included organisational structure,training and assessment,authorisation management and quality control.The programme was carried out in 8 clinical departments in the hospital,and the overall willingness of the clinical departments to develop early rehabilitation was improved since 2022.Conclusion This program can improve the operational efficiency of clinical departments and patient prognosis.

Objective? To investigate the hope level of elderly patients undergoing total knee arthroplasty (THA) and analyze its influencing factors, so as to provide evidence for improving the hope level and quality of life of patients after THA. Methods? A cluster random sampling method was used to select 308 patients with bilateral THA for the first time who were admitted to two ClassⅢ Grade A general hospitals in Harbin from January 2017 to July 2018. Questionnaire surveys were conducted using Herth Hope Scale, the Second Edition of Beck Depression Scale and Social Support Scale. Results? The total score of hope level in elderly THA patients was (29.96±8.72). Among them, 76.62% (236/308) had moderate to high level of hope and the total score of depression was (19.20±11.75) which was at a moderate level. There were significant differences in the hope level of patients with different gender, place of residence, educational level, marital status and family per capita monthly income (P＜ 0.05). The results of multiple stepwise regression analysis showed that age, sex, family income per capita, depression, negative coping style, subjective support and objective support were the influencing factors of elderly THA patients' hope level (P ＜ 0.05). Conclusions? The THA patients' hope are at a medium level. Medical staff should pay attention to the relevant factors affecting the level of hope, adopt targeted nursing intervention measures, give psychological guidance to patients, provide social support, and further improve the level of hope of the THA patients.