Objective To explore the effect of suction toothbrushing in oral care of patients with dysphagia.Methods sixty patients with dysphagia from the neurology department and rehabilitation department in our hospital were equally divided into the experiment group and the control group randomly: the former used suction toothbrushing for oral care and the latter physiological saline for oral care.The two groups were compared in respect of bad breath,oral cleanliness,time for conducting oral care,stomatitis, oral ulcer and pathogenic bacteria in oral cavity.Results The time for conducting oral care in the experiment group was significantly shorter than that in the control group(P<0.001).The score on oral cleanliness of the experiment group was significantly higher than that in control group(P<0.001).The bad breath,stomatitis or oral ulcer,and mucosa damage in the experiments group were all lower than those in the control group.The number of oral bacteria on the 5th day in the experiment group was smaller than that in the control group(P<0.005).Conclusion For the patients with dysphagia,the suction toothbrushing may be effective for cleaning the mouth,reducing oral complications and improving the satisfaction degree.

Objective:To investigate the clinical therapeutic effect of low-dose chemotherapy in advanced gastrointestinal cancer patients with weak physical condition, and to evaluate the related factors affecting the prognosis.Methods:The clinical data of 118 advanced gastrointestinal cancer patients with weak physical condition who were admitted to Xiamen Branch, Zhongshan Hospital, Fudan University from March 2018 to May 2019 were retrospectively analyzed. Kaplan-Meier method was used to make survival analysis in patients stratified by different factors, and log-rank was used to test. Multiple factor analysis of prognosis was performed by using Cox regression model. The association of clinicopathological factors with the prognosis was evaluated.Results:Among 118 patients, 16 (13.6%) cases were esophageal cancer, 41 (34.7%) cases were gastric cancer, 48 (40.7%) cases were colorectal cancer, 13 (11.0%) cases were pancreatic cancer. The overall survival (OS) rates of 6 months and 1-year were 44.1% and 10.2%, respectively. Survival analysis showed that patients with hemoglobin ≥100 g/L, serum albumin > 40 g/L and normal gastrointestinal function had better OS (all P < 0.05), while patients with physical status score of 3 scores and pain had worse OS (all P < 0.05). Cox multivariate analysis showed that after adjusting age and gender, hemoglobin level ( HR = 0.314, 95% CI 0.241-0.977, P = 0.001), pain ( HR = 2.016, 95% CI 1.697-7.038, P = 0.008) and gastrointestinal function ( HR = 1.751, 95% CI 1.607-6.080, P = 0.036) were independent influencing factors of OS in advanced gastrointestinal cancer patients with weak physical condition after receiving low-dose chemotherapy. Conclusions:Low-dose chemotherapy can still benefit advanced gastrointestinal cancer patients with weak physical condition. Hemoglobin level, pain and gastrointestinal function are independent prognostic factors for these patients.

Objective To evaluate out-patient individual health education prescription by diabetes nurse specialist on related knowledge of type-2 diabetes mellitus and blood glucose.Then combined with patient satisfaction surveys to explore the intervention value of out-patient individual health education prescription.Methods 100 out-patients with type-2 diabetes mellitus were chosen,and gave them individual health education prescription by evaluate individual condition and existing problems with previous treatment protocol unchanged,the prescription content included individual condition,diet,exercise,medication instructions and disease condition monitoring.The grasp of related knowledge of type-2 diabetes mellitus and satisfaction degree with diabetes nurse specialist were investigated by questionnaires.Results 3 months after individual health education,The grasp of related knowledge of type-2 diabetes mellitus,blood glucose and 2 hours' postprandial blood glucose greatly alleviated.Total satisfaction degree of patients reached 94%.Conclusions Paying attention to individualized instruction and out-patient individual health prescription in prevention and treatment of type-2 diabetes mellitus accords with humanization of nursing service,and is a powerful measure to improve health education quality.

Objective To compare and analysis of the clinical effect of Sanziyangqin decoction and ambroxol hydrochloride in the treatment of bronchiolitis.Methods 125 cases of bronchiolitis patients with complete data collected were retrospectively analyzed, randomly divided into control group ( 62 cases ) and observation group ( 63 cases ) , were treated with conventional ambroxol hydrochloride and Sanziyangqin decoction. The improvement of clinical symptoms, hospitalization time and treatment effect of the two groups were observed.Results The observation group of cough, wheezing, shortness of breath, throat phlegm and rales disappeared time and hospitalization time were significantly shorter than the control group, the difference was statistically significant (P<0.05).After treatment, the observation group of the total effective rate was 95.24%, significantly higher than the control group 72.58%, the difference was statistically significant (P<0.05).After Three months of treatment, the quality of life (GQOLI-74) was used to evaluate the scores of the patients in the two groups.The scores of the observation group were significantly higher than those of the control group, the difference was statistically significant (P<0.05).Before and after treatment in the two groups respectively were detected in blood and liver and kidney function, urine routine and other indicators, the detection and comparison were not abnormal, and the two groups before and after treatment were not found any adverse reaction.Conclusion The treatment of bronchiolitis in patients with Sanziyangqin decoction has the exact effect, compared with conventional ambroxol hydrochloride treatment can better improve the patient's clinical symptoms and signs, shorten the hospitalization time, improve the treatment efficiency and quality of life of patients, and there is no adverse reactions, is a safe and effective treatment method.

According to the course character and training objective, we analyzed the necessity of the experiment teaching reform of microbiology examination . The modules of employable Skills (MES) was applied to the experiment teaching of microbiology examination tentatively. On the basis of the needs of microbiology laboratory jobs, the contents of experimental course were integrated and optimized to skills module , comprehensive training module and application module , which include fourteen study units such as basic techniques of identification of bacteria,the separation and identifi-cation of pathogenic bacteria, microbiology examination of clinical specimen etc. Intensive teaching and multiplex teaching methods were applied to each module according to the module's characteristic, teaching objectives and cognitive rules of students. This teaching reform has achieved initial results.

In order to adapt to the requirements of the modern clinical laboratory to medical laboratory technology personnel operation ability,our hospital has modified professional microbiology experiment course to modular teaching from the traditional teaching mode.In the process of teaching experiment,the experiment course and clinical practice class are arranged,and the experiment course of microbiology is divided into five modules:basic skills,application,comprehensive training,extension,and clinical practice module.Basic skills module focuses on the foundation that students learn to observe the microbial morphology and master the basic operation technology,at the same time,cultivates the students' sterile ideas and biological safety;Application module pays attention to the detection of various types of bacteria,lets the student have as many times of trying as possible,battle-hardened;Comprehensive training module emphasizes students' ability of analyzing and resolving problems;Extension module guides students actively to make diffusing thinking and comprehensive analysis of problems;The final clinical practice module that combines theory and practice,further consolidates the basic operation skills,cultivates students' comprehensive ability,improves students' the independent working ability and professional thinking and habits.Five modules link up with each other closely and have progressive layers of the process.In sum,modular teaching motivates the students' interest in learning,solves the problem of students' insufficient operating ability,improves the teaching effect and provides a reform method for improving the quality of microbiological test experiment.

Objective To explore the correlation between family cohesion and adaptation and work adaptation in postpartum nurses with second child. Methods There were 155 postpartum nurses with second child collected from 4 hospitals in Chengdu of Sichuan Province between October and December 2017, by convenience sampling. Family Adaptation and Cohesion Evaluation Scale Ⅱ and Questionnaire of Return Adaptation for Postpartum Nurse were used in the investigation. Results The family real cohesion, ideal cohesion and dissatisfaction of coherence were (66.95 ± 8.37), (71.68 ± 6.45), (7.87 ± 5.13) points in this study, which were higher than norms: (63.90 ± 8.00), (68.80 ± 5.30), (6.40 ± 5.00) points, and there were significant differences (t=-3.086,-4.079,-2.403, all P<0.05) . The family real adaptation was (48.86 ± 7.33) points, which was less than norms: (50.90 ± 6.20) points, and there was significant difference (t=2.514, P<0.05). The ideal adaptation had no significant difference with norms (P>0.05). The dissatisfaction of adaptation was (9.36±5.22) points, which was higher than norms: (7.40 ± 5.30) points, and there was significant difference (t=-3.076, P<0.05). There were 24 (15.5%) nurses in extreme type family, 54 (34.8%) in intermediate type and 77 (49.7%) in balance type. The average score of work adaptation was (2.41 ± 0.76) points. The scores of work adaptation in nurses of extreme type family were lowest. Time since working, dissatisfaction of adaptation, dissatisfaction of coherence and hospital level were the influencing factors of work adaptation. Conclusions Nursing managers should face up to the situation of work adaptation in postpartum nurses, humanize their management, pay attention to the emotional state, promptly dispel their bad negative emotions, take measurements to improve the understanding of nurses'families and help them pass the adaptation period of returning to work.

Objective To construct a predictive model for septic shock based on the propensity score matching(PSM)method and validate its effectiveness.Methods A total of 114 patients with sepsis were enrolled as study objects,and were divided into septic shock group(40 patients)and sep-sis group(74 patients)according to whether they developed septic shock.PSM was performed with a ratio of septic shock to sepsis of 1∶2,resulting in the inclusion of 30 patients in the septic shock group and 60 patients in the sepsis group after matching.The levels of C-reactive protein(CRP),procalcito-nin(PCT),interleukin-6(IL-6),serum amyloid A(SAA),soluble endothelial protein C receptor(sEPCR),endothelial cell-specific molecule 1(ESM-1),clusterin(CLU),and the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score and Sequential Organ Failure Assessment(SOFA)score at admission were compared between the two groups.Cox proportional hazards re-gression analysis was used to identify the factors influencing septic shock,and a predictive model for septic shock was constructed and internally validated using the receiver operating characteristic(ROC)curve.Kaplan-Meier survival curves were plotted to analyze the differences in survival prog-nosis among patients with different expression levels of the indicators.Results After matching,there were no statistically significant differences in general information between the two groups(P＞0.05).At admission,the septic shock group had higher levels of serum PCT,CRP,SAA,IL-6,sEPCR,ESM-1,and higher APACHE Ⅱ and SOFA scores,as well as a lower level of serum CLU compared with the sepsis group(P＜0.05).Cox regression analysis showed that PCT,CRP,SAA,IL-6,sEPCR,ESM-1,APACHE Ⅱ score,and SOFA score were independent risk factors for septic shock(P＜0.05),while CLU was an independent protective factor(P＜0.05).The predictive model for septic shock,constructed based on these factors,showed an internal validation accuracy of 94.44％,an area under the curve of 0.950,a sensitivity of 93.33％,and a specificity of 96.67％.Dead patients had higher levels of PCT,CRP,SAA,IL-6,sEPCR,ESM-1,and higher APACHE Ⅱ and SOFA scores,as well as a lower level of CLU at admission compared with survivors(P＜0.05).Compared with patients with low expression levels or low scores,patients with high ex-pression levels of PCT,CRP,SAA,IL-6,sEPCR,ESM-1,and high APACHE Ⅱ and SOFA scores had higher fatality rates,while patients with high CLU expression levels had a lower fatality rate(P＜0.05).Conclusion The serum biomarkers including PCT,CRP,SAA,IL-6,sEPCR,ESM-1,CLU,and the APACHE Ⅱ and SOFA scores in sepsis patients are closely related to the oc-currence of septic shock and survival prognosis.The predictive model constructed by combining these indicators can accurately predict the occurrence of septic shock.

Objective:To explore the correlation between factors such as life events and the incidence of alopecia areata.Methods:A retrospective study was carried out to incorporate 550 patients diagnosed with alopecia areata and 550 healthy controls in the Department of Dermatology and Aesthetic Medicine, Honghui Hospital, Xi＇an Jiaotong University from December 2012 to February 2022. Based on the circumstances 6 months prior to the disease onset, patients independently completed the questionnaire survey, encompassing the Life Events Scale (LES) and the General Questionnaire on Alopecia Areata. Univariate analysis was implemented on the general conditions of both the alopecia areata patients and the healthy controls. Factors with statistically significant disparities were incorporated into the multivariate unconditional logistic regression model to analyze the influencing factors of the occurrence of alopecia areata.Results:In the alopecia areata group, there were 256 males and 294 females, with an average age of (32.6±13.1) years. In the healthy control group, there were 256 males and 294 females, with an average age of (34.5±13.3) years. Statistically significant differences were identified in occupational nature, family history, character, personality, alcohol consumption, consumption of spicy and irritating foods, negative life events, family life issues, and learning and work problems between the alopecia areata group and the healthy control group (all P<0.05). The outcomes of the multivariate unconditional logistic regression model indicated that occupational nature ( OR=2.268, 95% CI: 1.212-4.242, P=0.010), family history ( OR=9.692, 95% CI: 1.177-79.773, P=0.035), personality ( OR=1.807, 95% CI: 1.020-3.203, P=0.043), and learning and work problems ( OR=1.095, 95% CI: 1.010-1.188, P=0.029) were the influencing factors of the incidence of alopecia areata. Conclusions:Occupational nature, family history, personality, and problems in learning and work are the influencing factors of the incidence of alopecia areata.

Objective:To explore the clinical value of multidisciplinary team (MDT) treatment model for retroperitoneal soft tissue sarcoma (RPS) in the context of a regional medical center.Methods:The diagnosis and treatment of a patient with RPS in MDT model who were admitted to Xiamen Branch, Zhongshan Hospital, Fudan University in October 2020 were summarized, and the literature was reviewed.Results:The patient was a 59-year-old male, he was diagnosed with retroperitoneal INI-1-deficient poorly differentiated sarcoma with multiple systemic metastases. After several rounds of MDT discussions in Shanghai headquarter and Xiamen Branch of Zhongshan Hospital, Fudan University, the patient received systemic antitumor therapy combined with local therapy. After active treatment, the patient obtained a good curative effect. During the follow-up period, the liver and lung lesions slowly enlarged, and the treatment plan was adjusted. The patient had survived for more than 3 years.Conclusions:The diagnosis and treatment of RPS is complex, and the MDT model in the context of a regional medical center can help to formulate the optimal treatment plan for patients and may maximize the survival benefit of patients.