Objective To explore the effect iveness and safety of ProSeal laryngeal mask(PLMA)used in posterior spinal surgery. Methods Forty ASA Ⅰ - Ⅱ patients of thoracic-lumbar fracture were randomly divided into PLMA group and tracheal intubation (TI) group by systematic sampling with 20 cases each. PLMA or TI was inserted after intravenous anesthesia induction. The number of intubation, intubation time and time to surgery were recorded, systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were recorded induction (To), during intubation (T1), at 1 min (T2),3 min(T3), 5 min (T4), 10 min after intubation (T5), during extubation (T6). The intubation, extubation, and the maintain ventilation process of the respiratory and respiratory damage were recorded. Results All patients in PLMA group and TI group achieved satisfactory lung ventilation at the first attempt. There were no significant difference in the number of intubation, intubation time and time to surgery between two groups (P ＞ 0.05 ).SBP,DBP,HR at T1,T2,T3,T6 in TI group were significandy higher than To and those in PLMA group (P＜0.05). The intubation, extubation, and the maintain ventilation process of the respiratory and respiratory damage in TI group (5,25,36 cases) were more than those in PLMA group (0,1,6 cases)(P ＜0.05).Conclusion PLMA for posterior spinal surgery is safe and effective.

Objective To compare the effect of proseal laryngeal mask airway(PLMA)and esophageal tracheal combitube(ETC)used in adult patients of difficult airway in perioperation.Methods Forty ASA Ⅰ-Ⅱadult patients of difficult airway were randomly divided into two groups:PLMA group and ETC group,each group was 20 cases.After intravenous anesthesia induction,PLMA or ETC was inserted by routine methods.The number of intubation,intubation time and time to surgery were recorded.The systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)were recorded before intubation (T_1),during after intubation(T_2),at 1 min(T_3),5 min(T_4),10 min(T_5)after intubation,during extubation(T_6).The intubation,the extubation and the maintain ventilation process of the respiratory complications and respiratory damage were recorded.Results All patients in PLMA group and ETC group achieved satisfactory lung ventilation at the first attempt.The number of intubation,intubation time and time to surgery were not different between the two groups(P＞0.05).SBP,DBP,HR at T_2,T_3,T_6 in ETC group [T_2:(143.2±11.4)mm Hg(1mm Hg=0.133kPa),(86.9±10.7)mm Hg,(145.8±10.2)times/min,T_3:(140.0±11.3)mm Hg,(84.5±10.7)mm Hg,(142.5±11.5)times/min,T_6:(147.7±11.3)mm Hg,(87.2±9.7)mm Hg,(145.4±10.9)times/min]were significantly higher than those in PLMA group[T_2:(123.5±12.7)mm Hg,(72.6±11.4)mm Hg,(129.0±11.0)times/min,T_3:(120.0±11.5)mm Hg,(69.7±10.5)mm Hg,(125.7±10.6)times/min,T_6:(122.5±11.6)mm Hg,(71.4±9.4)mm Hg,(127.8±11.3)times/min]and at T_1 in ETC group[(122.7±12.1)mm Hg,(74.1±9.6)mm Hg,(121.0±11.8)times/min](P<0.05).Respiratory complications and damage were no significant difference between the two groups(P＞0.05).Conclusion PLMA and ETC can achieve satisfactory lung ventilation used in adult patients of difficult airway in perioperation,they are safe and effective airway management device,but PLMA used in adult patients of difficult airway in perioperation is better than ETC in keeping stable hemodynamics and producing less stress responses.

Objective To investigate the feasibility of repairing the radius defect with inductive bone regeneration membrane combined with freezed allogenic bone. Methods Preparation PLGA/bBMP+IGF-Ⅱ+ bFGF complosite was prepared as artificial periosteum. Twenty seven rabbits with 1.0 cm long right radius segmental osteoperiosteum defect were werved as the animal model, and randomly assigned to 3 groups with 9 in eath group; Group A: the defects were connected with the PLGA/bBMP+IGF-Ⅱ+bFGF membrane and allogenic bone; Group B: the defects were treated with the PLGA/bBMP+IGF-Ⅱ+bFGF membrane; Group C: the defects were implanted only woth allogenic bone grafts. Animals were killed at 2, 4, 8 weeks postoperation respectively. The healing was study with radiological, histological and immunological methods. Results The osteogenic ability in PLGA/bBMP+IGF-Ⅱ+bFGF group was superior to that in the other groups. The defects of group A ware fully repaired at week 8; bony bridging under remodeling was observed in group B; and the putrescence of allogenic bone which was packaged by mass of connective tissue was observed with group C; Group A caused lower titer of antibody than group C and inhibited lymphocytes reproduction in vitro; There was significant difference between group A and group C. Conclusion PLGA/bBMP+IGF-Ⅱ+bFGF artificial periosteum had provided a excellent osteoinduction condition. Artificial periosteum combined with freezed allogenic bone can effectively promote the rapair of radius defects of rabbit.

Objective To investigate the setup error for nasopharyngeal carcinoma (NPC) patients with poor compliance using kV cone-beam computed tomography,and to calculate the expansion margin from the clinical target volume (CTV) to planning target volume (PTV).Methods In 45 NPC patients from 2013 to 2015,the setup error,95％ confidence interval (CI)-1 for random error,and PTV-1 value were calculated.Moreover,in 16 NPC patients with poor compliance based on five verifications (random error not within 95％ CI-1),the setup error,95％ CI-2 for random error,and PTV-2 value were calculated.For the 16 special patients,PTV-1 and PTV-1 combined with PTV-2 were used to develop the plan-1 and plan-2,respectively.The dosimetric difference between plan-1 and plan-2 was evaluated.Results Both PTV-1 and PTV-2 had the largest expansion margin in the y direction.The CTV of plan-1 could not meet the requirement of the prescription dose after the setup error was introduced.Compared with plan-1,the V95％ and D95 values for the CTV of plan-2 were increased by 6.26％ and 4.43％,respectively.The D01 value was significantly larger in plan-2 than in plan-1 (P=0.005),which,however,met the clinical requirement.Conclusions In patients with poor compliance,the dose to target volume can be effectively elevated and the normal tissue can be spared from damage when PTV-1 combined with PTV-2 is selected as expansion margin.

Objective To explore the feasibility and effect of systematic innovative nursing instruments for patients with re-plantation of severed fingers.Methods Sixty-six patients with replantation of severed fingers before improvement from June 2013 to December 2014 and 96 re-plantation patients from January 2015 to August 2016 after improvement were enrolled as control group and experimental group,respectively.The control group was given traditional nursing,while the experimental group used innovative nursing instruments for overall car,severed finger comfort,the incidence of arterial crisis and venous crisis,finger survival rate were compared.Results Experimental group had better indicators in comfort,incidences of arterial crisis and venous crisis,survival rate of severed finger than the control group (P ＜ 0.05).Conclusion Series of nursing instruments can deepen nursing quality for severed finger re-plantation patients.

Objective To explore the feasibility and effect of systematic innovative nursing instruments for patients with re-plantation of severed fingers.Methods Sixty-six patients with replantation of severed fingers before improvement from June 2013 to December 2014 and 96 re-plantation patients from January 2015 to August 2016 after improvement were enrolled as control group and experimental group,respectively.The control group was given traditional nursing,while the experimental group used innovative nursing instruments for overall car,severed finger comfort,the incidence of arterial crisis and venous crisis,finger survival rate were compared.Results Experimental group had better indicators in comfort,incidences of arterial crisis and venous crisis,survival rate of severed finger than the control group (P ＜ 0.05).Conclusion Series of nursing instruments can deepen nursing quality for severed finger re-plantation patients.

Objective:To analyze the number of appeals volume and causes for complaints received by the government hotline against a hospital in Yangzhou during the pandemic of novel coronavirus pneumonia(hereinafter referred to as COVID-19), so as to provide reference for handling such hotline complaints during pandemics.Methods:Retrospective comparative analysis was made on the " 12345" government hotline work orders received from July 28, 2020 to August 28, 2020(routine prevention and control period) and July 28, 2021 to August 28, 2021(pandemic closure and control period). A descriptive analysis was made on the cause types of complaints and the distribution of departments in question, along with an analysis of the correlation between the cumulative number of cases of pandemic development and the number of complaints using Spearman rank correlation method.Results:The number of work orders for a hospital in Yangzhou during the pandemic control period(659 cases) was 7.7 times higher than that in the routine control period(76 cases). Management problems accounted for 96.7%(637 cases) in the level-1 type of the causes of complaints during the closure and control period of the pandemic, and workflow problems accounted for 90.9%(599 cases) in the level-2 type, which increased by 28.3 and 27.7 percentage points respectively compared with the routine prevention and control period; The highest proportion in the level-3 type of causes for complaints during the closure and control period of the pandemic was administrative management, accounting for 87.9%(579 cases). The departments being complained the most during the pandemic incubation period, outbreak period and recovery period of the pandemic were the fever clinic, oncology department and discharge center respectively. The cumulative number of cases of pandemic development was positively correlated with the number of complaints.Conclusions:During the COVID-19, the handling of the government hotline should be analyzed along with the causes of complaints, focusing on patients′ demands, providing timely feedback, developing collaborative management measures, and achieving accurate policy implementation.

Objective To explore the reasons for junior contract nurse′ s resignation and their reemployment intentions, and to provide a reference for the development of strategies to improve contract nurses′management. Methods A total of 82 nurses who resigned from the hospital were investigated with a self-designed questionnaire about the reasons of leaving, and they were interviewed by semi-structured questionnaire. Results The top two reasons for leaving were hardly to making friends (63. 41% ) and inconvenience of taking care family (58. 54% ). Besides, working stress, limited space for professional development, the intense medical environment were also the reasons for resignation. The nurses with a bachelor degree were more than those with an associated degree among those who resigned for limited space for professional development. After leaving, 70. 73% nurses would continue to do clinical nursing jobs in the second or the third degree hospitals where were near their home. Conclusions Further implementation of the humanity management measures, paying more attention to nurse′ s personal and family problems, reducing nurses′ working pressures and effectively guide can increase the loyalty and recognition of contract nurses, so it may reduce the retention of resignation.

Objective To explore application effects of informationalized simulated ward in the pre-job standardized training for new nurses. Methods There were 103 new recruited nurses in 2014 and 100 new recruited nurses in 2015 of Subei People's Hospital of Jiangsu Province who were investigated in the study using convenient sampling method. New nurses were divided into the control group (nurses recruited in 2014) and observation group (nurses recruited in 2015) according to the schedule time of induction training. Nurses in the control group received conventional pre-job standardized training, while nurses in the observation group used informationalized simulated ward based on the conventional pre-job standardized training. The theoretical knowledge, clinical competence, and the satisfaction degree of new nurses after the pre-job standardized training were compared between two groups. Results The scores of theoretical knowledge and clinical competence in the control group were (93.05±5.74) and (85.47±4.16), which were higher than those in the control group [(87.70±5.46) and (80.84±3.55)]. The differences were statistically significant (t=-7.338, -9.201; P<0.001). The satisfaction degree of new nurses in the observation group was 100.0%, which was significantly higher than that in the control group (93.2%) (χ2=8.005, P=0.005). Conclusions Informationalized simulated ward can improve pre-job standardized training quality of new nurses, which is worthy clinical promotion.

Endothelial cell injury is a major contributor to cardiovascular diseases.The 2,3,5,4’-Tetrahydroxystilbene-2-O-β-D-Glucoside (TSG) contributes to alleviate human umbilical vein endothelial cells (HUVECs) injury through mechanisms still know a little. This study aims to clarify the TSG effects on gene expression (mRNA and microRNA) related to oxidative stress and endoplasmic reticulum stress induced by H2O2 in HUVECs. We found that TSG significantly reduced the death rate of cells and increased intracellular superoxide dismutase activity. At qRT-PCR, experimental data showed that TSG significantly counteracted the expressions of miR-9-5p, miR-16, miR-21, miR-29b, miR-145-5p, and miR-204-5p. Besides, TSG prevented the expression of ATF6 and CHOP increasing. In contrast, TSG promoted the expression of E2F1. In conclusion, our results point to the obvious protective effect of TSG on HUVECs injury induced by H2O2, and the mechanism may through miR16/ATF6/ E2F1 signaling pathway.