Objective To explore preventive effect of evidence-based nursing intervention program in patients at high risk of pressure ulcer in intensive care unit.Methods A total of 227 patients with risk evaluation score of Braden leas than 12 were randomly divided into the observation group (125 cases) and the control group (102 cases).The control group was only given regular nursing interventions.Patients in the observation group received evidence-based nursing interventions : including turning over per 2 hours, turning prostration to 30 degree left to fight inclined position, raising patient's head lower than 30 degree and putting a soft pillow under his/her heels; the patients whose risk evaluation score of Braden was less than 7, with cervical fracture or turning ever was limited by her/his situation needed to use air bed; comfeel transparent paste was used on the surface probably suffered from skin ulcer;, giving PN or EN according to patients' nutritional condition; keepping the skin around anus dryness.The incidence of pressure ulcer be-tween the two groups was compared.Results The incidence rate of pressure ulcer was siguificantly lower in the observation group than that in the control group.The occurring time significantly delayed and the sit-uation significantly better.Conclusions The evidence- based nursing inventions can lower the incidence rate of unavoidable pressure ulcer,reflect the scientific and artistic characteristics of nursing care, also effi-cient allocate limited nursing resources and reduce the incidence of pressure ulcer.

Objective To explore the impact of sulfentanyl on sufentanil epidural block during abdominal panhysterectomy. Methods 90 patients scheduled for panhysterectomy were randomly divided into three groups. Tthe control group received epidural administration of 1% ropivacaine of 0.2 mL/kg after 2% idocaine of 3 mL , while the study group 1 received 10μg sufentanil and the study group 2 received 20μg sufentanil in addition to the medications used in the control group. The anesthetic effect, changes in vital signs, and incidence of adverse reactions were compared among the three groups. Results In group S1 and group S2, the onset of epidural anesthesia was faster , time to the highest plane of sensory blockade and time to degree 3 in the Bromag scores were faster , duration of sensory blockade was longer , and OAA/S score was better , as compared with group D , with significant statistical significances (P<0.01);and the effect was better in group S2 than in group S1. There was no difference among the three groups in adverse reactions. MAP , HR and SPO2 were lower in groups S1 and S2 than in group D during the procedure, with a statistical difference (P<0.05). Conclusions Proper dose of sufentanil plays a positive role in ropivacaine epidural block during panhysterectomy , not only increases the onset of anesthesia, but also makes the anesthestic effect better, and has higher safety It is worth popularizing clinically.

Obejective To explore the effect of combined use of dexmedetomidine and ultra-low dose naloxone on postoperative hyperalgesia induced by remifentanil. Method 80 ASA gradeⅠ-Ⅱ female patients who were scheduled to perform endoscopic sinus surgery (ESS) were randomly divided into four groups: purely remifentanil group (group R) and remifentanil plus different dosage dexmedetomidine and ultra-low dose naloxone group (group RDN1 ~ RDN3). Then the postoperative VAS on 30 min, 1 h, 2 h, 4 h, 8 h, 12 h and 24 h together with the firstpostoperative pain time , PCA press numbers , fentanyl usage and adverse reaction rate were recorded and evaluated. Results Average VAS of group R are higher than other groups in all 7 time points at the adjusted significant level of 0.0083, and group R > group RDN1 > group RDN2 > group RDN3, while differences between group RDN2 and RDN3 in all time points are not statistical significant.There is no difference between group RDN1 and group RDN2 inthe first postoperative pain time and the PCA press time at 1h after operation. Difference between group RDN2 and group RDN3 in the PCA press time at 24 h after operation was not significant, and the fentanyl usage of RDN groups are significantly less than group R. Conclusions Combined use of dexmedetomidine and ultra-low dose naloxone induced by remifentanil can improving patients′postoperative hyperalgesia , effect increase with the dose of dexmedetomidine increas , and the increasement is more sensitive in acute pain.

Objective To evaluate the X-ray diagnosis value of intestinal malrotation in adults.Methods The X-ray findings of 16 cases with intestinal malrotation confirmed by surgery were analyzed retrospectively. All of them were taken X-ray plain films, 11 cases were taken alimentary tract barium meal,and 5 cases were taken barium enema. Results Eight cases were found incomplete obstruction of the duodenum, and 2 cases were found low small intestine obstruction on the X-ray plain films. The alimentary tract barium meal showed 4 cases with dilatation and incomplete obstruction of the duodenal bulb to horizontal segment,and the distal end of narrowing intestine appeared as a rat tail,7 cases showed the abnormal duodenal location and shape,called "strip" sign. Four cases were found abnormal duodenojejunal flexure by barium enema examination. Conclusion The alimentary tract barium meal and barium enema examination has great diagnosis value for intestinal malrotation in adults.

Autoantibodies ; COVID-19 ; Humans ; Singapore/epidemiology*

Objective:To evaluate the optical performance of two aspheric intraocular lenses (IOL) AcrySof IQ SN60WF and Proming A1-UV with identical negative spherical aberration values, using the optical bench OptiSpheric IOL R&D through an in vitro study. Methods:The optical performance of + 20.0 D blue-light filtering SN60WF and monofocal high-order aspheric non blue-light filtering A1-UV IOL was evaluated through cornea models with the spherical aberration of 0 μm (ISO-1) and + 0.28 μm (ISO-2) under apertures of 3.0 mm and 4.5 mm via the optical bench OptiSpheric IOL R&D.The modulation transfer function (MTF) and USAF 1951 resolution test chart were employed to measure the IOL with centering, decentration of 0.3, 0.5, 0.7, 0.9 and 1.1 mm, as well as tilt of 3°, 5°, 7°, 9° and 11°.The spectral transmittance of IOL was measured with the UV-3300 UV-VIS spectrophotometer.Results:Compared with the A1-UV IOL, the spectral transmittance of SN60WF for blue light with wavelengths of 400-500 nm was significantly reduced, which effectively reduced the passage of blue light.At an aperture of 3.0 mm, the MTF values at 100 lp/mm spatial frequency for the centered SN60WF and A1-UV were 0.576 and 0.598 under ISO-1 corneal measurement conditions, 0.564 and 0.563 under ISO-2 conditions.At an aperture of 4.5 mm, the MTF values were 0.238 and 0.404 under ISO-1 corneal measurement conditions, and 0.438 and 0.339 under ISO-2 conditions.The MTF values of A1-UV and SN60WF at 3.0 mm aperture and 100 lp/mm spatial frequency under ISO-1 corneal measurement conditions were larger than those under ISO-2 corneal measurement conditions.Under ISO-1 corneal measurement conditions with a 3.0 mm aperture, A1-UV had a better optical quality compared to SN60WF, whereas under ISO-2 corneal measurement conditions, the optical quality of both IOLs was similar.Under the 3.0 mm aperture, the MTF values of SN60WF and A1-UV at a decentration of 0.3 mm and 100 lp/mm spatial frequency were 0.414 and 0.571 under ISO-1 corneal measurement conditions, 0.438 and 0.512 under ISO-2 corneal measurement conditions, respectively.The MTF values of SN60WF and A1-UV at a tilt of 3° were 0.522 and 0.597 under ISO-1 corneal measurement conditions, and 0.532 and 0.531 under ISO-2 corneal measurement conditions.The MTF values and USAF resolution test chart of A1-UV had no significant change between the two corneal measurement conditions.When subjected to equal degrees of decentration or tilting, except for the ISO-1 corneal measurement conditions at a 4.5 mm aperture, the MTF values of A1-UV showed a gradual decline across various spatial frequencies compared to SN60WF.With the increase in aperture size, the impact of IOL decentration or tilting on MTF values and USAF 1951 resolution test chart became more notable for A1-UV relative to SN60WF.Conclusions:The SN60WF IOL effectively filters blue light within the wavelength range of 400-500 nm.However, when both IOL experience decentration greater than 0.3 mm or tilting beyond 3°, the optical quality of the IOL will decline.A1-UV has a distinct advantage over SN60WF in terms of resistance to both decentration and tilting-induced optical performance degradation in vitro.

AIM: To assess the repeatability and agreement of higher-order aberration obtained by adaptive optics visual simulator(VAO)compared with OPD-Scan Ⅲ.METHODS: A cross-sectional study was conducted from August to September 2023, including a total of 204 patients(204 eyes)with myopia whose right eyes were measured. The examinations were performed by the same skilled examiner using both devices separately. The VAO device was used to measure higher order aberrations of orders 3 to 6 at a pupil diameter of 4.5 mm, while both the VAO and OPD-Scan Ⅲ devices were utilized to measure total higher-order aberration(tHOA), spherical aberration(SA), coma aberration(Coma), and trefoil aberration(Trefoil)of the entire eye at pupil diameters ranging from 3 to 6 mm. Furthermore, the repeatability of whole eye aberration measurements obtained with the VAO device was evaluated and the agreement of the two devices was assessed.RESULTS: The whole-eye higher-order aberrations measured by VAO demonstrated excellent repeatability(0.767≤ICC≤0.941, Sw<0.01 μm, TRT<0.1 μm). There was no statistically significant difference in Coma measured by VAO or OPD-Scan Ⅲ for pupil diameters ranging from 4 to 6 mm(P>0.05), while a statistically significant difference was observed in whole-eye tHOA of other pupil diameters(all P<0.05). The agreement of aberration measurements for each order between VAO and OPD-Scan Ⅲ for 3 mm pupil diameters, SA at 4 and 5 mm pupil diameter and Coma at 4 mm pupil diameter showed a 95% limit of agreement(LoA)<0.1, indicating good agreement; however, poor agreement was found for the remaining aberration measurements at different pupil diameters, with a 95%LoA>0.1, and there were significant differences in higher-order aberrations measured by two devices under a pupil diameter of 3 mm(r=0.218-0.317, P<0.01), 4 mm(r=0.406-0.672, P<0.01), 5 mm(r=0.538-0.839, P<0.01 and r=0.030-0.109, P>0.01)and 6 mm(r=0.369-0.766, P<0.01).CONCLUSION: The VAO demonstrates favorable repeatability when assessing whole-eye higher order aberration under pupil diameters of 3-6 mm. However, there is inadequate agreement and interchangeability in whole-eye higher order aberration at 3-6 mm pupil diameter between VAO and OPD-Scan Ⅲ for clinical purposes.