BACKGROUND: Unilateral spinal epidural anesthesia with ropivacaine can reduce the perioperative pain in the elderly undergoing hip or knee arthroplasty, but choosing which concentration of small dose hypobaric ropivacaine is an issue of concern.OBJECTIVE: To explore the anesthetic and analgesic effects of unilateral spinal epidural anesthesia with different concentrations of low dose hypobaric ropivacaine in senile knee or hip replacement.METHODS: Ninety patients undergoing knee or hip replacement in the Henan Province Hospital of TCM from August 2014 to December 2015 were enrolled, and randomized into 0.15%, 0.5% and 0.25% ropivacaine groups (n=30 per group), followed by spinal epidural anesthesia at L3-4 or L2-3 lumbar interspace, respectively.RESULTS AND CONCLUSION: (1) The order of the flat subsided time and motor block recovery time was as follows:0.15% ropivacaine group < 0.25% ropivacaine group < 0.5% ropivacaine group; the onset time of motor block was longest in the 0.25% ropivacaine group, followed by 0.5% ropivacaine group, and shortest in the 0.15% ropivacaine group (all P < 0.05). (2) The order of the visual analogue scale scores at 1, 5, and 10 hours after anesthesia and 24 hours postoperatively was as follows: 0.5% ropivacaine group < 0.25% ropivacaine group < 0.15% ropivacaine group (P < 0.05). (3) The change levels of heart rate and blood pressure were highest in the 0.5% ropivacaine group, followed by 0.15% ropivacaine group, and lowest in the 0.25% ropivacaine group. (4) The incidence of adverse events was highest in the 0.5% ropivacaine group, followed by 0.15% ropivacaine group, and lowest in the 0.25% ropivacaine group (P < 0.05). (5) To conclude, 3 mL of 0.25% ropivacaine exhibits desired anesthetic effect.

Objective To establish and implement a central venous linemanagement information system based on the hospital information system (HIS). Methods The central venous line information management system was developed by the infusion therapygroup and the information technology department according to the requirement of completed central venous line management and the Chinese intravenous nursing practice standard. Results ① A complete information management system was constructed for central venous line from placement, maintenance and management of complications to drawing tube, and it operated smoothly. ②Totally, 4304 cases of PICC, 14,330 cases of CVC and 123 cases of PORT were collected from January 2016 to December 2017. The information of the maintenance number, catheter retention time, complications can be counted. Conclusions The central venous vein management information management system can realize the whole-process management, and ensure the continuous evaluation, maintenance and tracking of the patient's central venous line, making detailed statistical analysis of catheter- related complications, whichcan provide reliable basis for continuous nursing quality improvement.

The development of information technology in the medical industry is accelerating the construction of 3-level rehabilitation networks centering on community-based rehabilitation, which is based on the Internet and in combination with the Internet of things(IOT). A municipal rehabilitation hospital cooperated with the health centers of sub-district communities in the city to build a remote rehabilitation network based on IOT technology, for rehabilitation training of community stroke patients. The two sides worked out a cooperation scheme on project management, designed and built a remote community rehabilitation management model. Under the remote monitoring and equipment data IOT, the medical team of the municipal rehabilitation hospital could formulate the therapeutic plan according to the immediately obtained relevant functional evaluation data, and the medical team of the community health service center was responsible for the implementation of the plan. Fifty-three patients in the experimental group received the training of remote lower limb intelligent feedback system based on IOT together with routine rehabilitation training. After 8 weeks of treatment, the functional evaluation data of the two groups were improved in varying degrees( P< 0.05), but the improvement of the experimental group was significantly better than that of the control group( P < 0.05). Remote rehabilitation under the construction path of remote rehabilitation network based on IOT technology could significantly promote the improvement of post-functional rehabilitation of community stroke patients. This study can provide reference for the construction of three-level remote rehabilitation networks based on IOT and the implementation of home-based remote rehabilitation therapy in the future.