Objective:To explore the clinical effect of ultrasound evaluation of fiberoptic bronchoscope (FB) guided tracheotomy, which can provide help for difficult tracheotomy and new operators.Methods:The operating protocol was standardized for ultrasound evaluation of FB guided tracheotomy. Ten patients with difficult tracheotomy admitted to the department of critical care medicine of Donge Hospital from October 2019 to January 2020 were enrolled. According to this protocol, FB guided tracheotomy was performed under the ultrasound evaluation, and the amount of blood loss, operation time and related complications during procedures were collected.Results:The preparation of supplies, personnel, patients and the operation, the process of FB guided tracheotomy under the ultrasound evaluation were standardized. When tracheotomy was preformed for patients with difficult tracheotomy, it was necessary to use ultrasound first to evaluate the neck condition and vascular disorientation of patients, and the tracheotomy plan (tracheotomy site, incision size, and incision depth) was designed, and then the tracheotomy process was monitored under the guidance of FB. Among the 10 patients with difficult tracheotomy, 6 were male and 4 were female; body mass index was (32.2±1.4) kg/m 2. Tracheotomy was successfully completed within 10 minutes in all the 10 patients, with less than 5 mL blood loss, and no complications occurred. Conclusion:Ultrasound evaluation of FB guided tracheotomy can improve the clinical operations and ensure patient safety.

Objective To explore the influences of the network medical health management on the coping styles , hope level and quality of life in patients with primary kidney cancer surgery .Methods The patients of control group received normal health management and the participants included 77 kidney cancer patients who were laboratory diagnosed during March 2011 and September 2012 .The patients of intervention group received the network medical health management based on the normal health management and the participants included 79 kidney cancer patients who were laboratory diagnosed during March 2013 and September 2014 .The coping styles , hope level and quality of life before and after the intervention were compared between the two groups .Results Before the intervention , the coping styles and the hope level had no statistical differences between the two groups (P>0.05).After the intervention for the coping styles , the intervention group had higher scores of the positive coping style (25.44 ±2.61) and lower scores of the negative coping style (9.76 ±1.89) and presented statistical differences compared with that of the control group ( t=-10.468, 7.572;P <0.01).For the hope level, there was no statistical significance between two groups before intervention (P >0.05); however, after intervention, the intervention group had higher scores of positive attitudes (14.5 ±2.6), positive behaviors (15.1 ±2.4) and close contact with people (15.6 ±2.1), and presented statistical differences with that of the control group (t=4.965, 5.569, 4.965; P<0.05).For the quality of life, there were no statistical differences for the dimensions of PF , RF and DY (P>0.05) but the intervention group performed better on other 12 dimensions′scores ( P <0.05 ); the quality of life in the intervention group was better than that of control group .Conclusions The network medical health management should be further applied to the clinical practice , because it can significantly improve the coping styles , hope level and quality of life among the patient with primary kidney cancer surgery .