Objective The difficulty of full thoracoscopic Ivor-Lewis is the lack of a safe and low cost anastomosis.By improving the surgical process,to explore the application of circular stapler in the intrathoracic esophagogastric anastomosis.The thoracoscopic operation mode of esophageal cancer changes from simply following the McKoewn procedure to Ivor-Lewis and McKoewn procedure.Methods Retrospective analysis 123 cases of implementation thoracoscopic esophageal cancer from July 2009 to February 2013,which including the cases of intrathoracic anastomosis and cervical anastomosis.Divided it into two groups:intrathoracic anastomosis groups,which including thoracoscopic esophagectomy resection,gastroesophageal anastomosis and anastomotic pedicled omentum embedding,the cervical anastomosis groups,which including thoracoscopic esophageal free and gastroesophageal neck anastomosis.To comparing the incidence of ARDS,postoperative hoarseness,anastomotic complications (Anastomotic leakage and anastomotic strictures within two months after surgery),guardianship time of ICU and postoperative hospital stay between the two groups.Results All the patients were no deaths.The cervical anastomosis group operative time was significantly lower than the intrathoracic anastomosis group.The incidence of anastomotic fistula and anastomotic stricture of intrathoracic anastomosis group was significantly lower than that of the cervical anastomosis group,total hospitalization time of the intrathoracic anastomosis group were significantly lower than that of the cervical anastomosis group,there is no significant differences in postoperative hoarseness and ARDS incidence between the two groups.Conclusion For the lower esophageal carcinoma,it is technically mature and safe to apply the circular stapler for Ivor-Lewis surgery and sleeve omentumembedding anastomotic technique in full thoracoscopic,and the technology should be widely applied; for the upper esophagealcarcinoma,McKoewn procedure should be applied.

Occupational therapy is an important part of rehabilitation medicine. There is movement, feel, swallowing, speech, vision,cognitive, psychological and social relations dysfunction in stroke patients. Occupational therapy play an important part in the whole processof intervention for stroke patients, and help them improve their quality of life.

Objective In order to improve the diagnosis accuracy , 18F-FDG PET/CT results of 169 cases of lung lesions were analyzed. Methods The data of 169 pathological diagnosed patients were collected. SPSS 18.0 was used for the data analysis. Results In 169 cases, 122 cases were proved malignant by patholog-ical diagnosis, in which 110 cases were correctly diagnosed by PET/CT. 47 cases were proved benign by patho-logical diagnosis, in which 15 cases were correctly diagnosed by PET/CT. The sensitivity was 90.2%, specificity was 31.9%, and the accuracy was 74.0%. Conclusion In order to improve the accuracy rate of PET/CT exam-ination and reduce the existence of false positive cases and false positive cases , we should estimate SUV (max) objectively and diagnose according to the size of the lesion , clinical history and laboratory results.

Objective To explore the community rehabilitation guidance for patients of vertebral osteoporosis fracture after percutaneous vertebroplasty. Methods The study collected 262 cases of osteoporotic fracture patients in community rehabilitation stage after PVP who leaved hospital from February 2010 to February 2014. Using the methods of drugs, diet, common exercise and systematic back muscle exercise. According to block random number method, the participants were divided into two groups: group A ( general guidance) and group B ( specialized guidance) . The incidence of the pain relapse and the fracture relapse would be observed. Results In group A, the incidence of pain relapse were 26 cases and fracture relapse were 6 cases; in group B, the incidence of pain relapse were 12 cases and fracture relapse were 5 cases. The differences of the incidence in pain relapse between two groups had statistical significance (χ2 =5. 54,P <0. 05), but the incidence of fracture relapse had no statistical difference (χ2 =0. 07,P>0. 05). Conclusions The community rehabilitation nursing is an important stage of holistic nursing mode and a guarantee to fully play the curative effect on the percutaneous vertebroplasty.

Objective:To understand the cognition and attitude of nursing home managers towards physical constraints for the elderly, so as to clarify the direction and obstacles for improving physical constraints in nursing homes, and provide reference for regulating and reducing physical constraints for the elderly.Methods:Using phenomenological research methods, 15 nursing home managers who met the inclusion criteria were selected as the research subject for semi-structured in-depth interviews from June to September 2022. The Colaizzi 7-step analysis was used to analyze, summarize data, and extract themes.Results:The cognition and attitude of nursing home managers towards physical constraints were summarized into 4 themes, namely, the understanding of physical constraints by nursing home managers from both theoretical and practical perspectives, nursing home managers held different attitudes towards the use of physical restraint, reasonable and standardized implementation of physical restraint was the direction for improving physical restraint in nursing homes, improving the use of physical constraints in nursing homes faced obstacles from various aspects.Conclusions:There are currently many problems with the use of physical restraint for elderly people in nursing homes. Nursing home managers should continuously improve their cognition of constraints and actively play their important role in the process of constraint management. All sectors of society should pay attention and support to physical constraints for the elderly.