Objective To develop a lower limbs rehabilitative apparatus and explore its effects. Methods From January to September, 2016, 28 children with spastic cerebral palsy were divided into control group (n=14) and observation group (n=14) randomly. The control group received routine rehabilitation, while the observation group received self-made lower limbs rehabilitative apparatus training addition-ally. They were assessed with Gross Motor Function Measure (GMFM)-88 and Berg Balance Scale (BBS) before and three months after treatment. Results There was no significant difference in the scores of GMFM-88 and BBS between two groups before treatment (P>0.05), while they increased after treatment (t>6.124, P<0.001), and were higher in the observation group than in the control group (t>2.329, P<0.05). Conclusion Self-made lower limbs rehabilitative apparatus could help to improve the gross motor function and balance function in children with spastic cerebral palsy.

Objective To study the relationship between low birth weight and hemangioma, as well as the efficacy of dye laser alone and in combination with intralesional drugs in the treatment of cutaneous vascular anomalies. Methods A questionaire was designed and delivered to assess the health status of 209 children with hemangioma and 100 normal control children, as well as the situation of their mothers during pregnancy.Pulsed dye laser was utilized to treat capillary hemangioma, venular malformation, spider angioma and pyogenic granuloma, and pulsed dye laser plus intralesional drugs to manage mixed hemangioma, followed by evaluation of therapeutic efficacy. Results Low birth weight babies amounted to 33.49% in 209 children with hemangioma and 9% in normal controls (u = 4.621, P ＜ 0.05). The effective rate of pulsed dye laser was 83.69% for capillary hemangioma, 92.59% for venular malformation, 100% for spider angioma and 50% for pyogenic granuloma. An effective rate of 95.59% was observed for pulsed dye laser plus intralesional drugs in the treatment of mixed hemangioma. Conclusions Low birth weight has a close relationship with the development of hemangioma. A favorable efficacy has been observed for pulsed dye laser in the treatment of capillary hemangioma, venular malformation and spider angioma, and for pulsed dye laser plus intralesional drugs in the treatment of mixed hemangioma.

Objective:To construct and apply the quality sensitive indicator system for eye, ear, nose and throat specialized nursing in Operating Rooms, in order to provide a basis for evaluating the quality of nursing work in specialized Operating Rooms.Methods:Using the three-dimensional quality evaluation model of "structure-process-result", a preliminary framework for quality sensitive indicators of eye, ear, nose, and throat specialty nursing in the Operating Room was developed using literature search and expert interviews. The final indicator system and weight were determined through two rounds of Delphi expert inquiry. In January 2023, targeted training was conducted in the Operating Room of Eye & ENT Hospital of Fudan University based on the established quality indicator system. The difference of outcome indicators in the sensitive index system of nursing quality in Operating Room of our hospital in December 2022 (before training) and February 2023 (after training) were compared.Results:The final version of the quality sensitive indicator system for eye, ear, nose and throat specialty nursing in the Operating Room included three primary indicators, 10 secondary indicators and 36 tertiary indicators. The positive coefficients of the two rounds of consultation with experts were both 100.00%, and the authoritative coefficients were 0.917 and 0.931. After applying the quality indicator system, the failure rate of emergency drills related to difficult airways among nursing staff in the Operating Room of the Eye, Ear, Nose and Throat Department decreased from 4.86% to 0.54% ( P<0.05). The failure rate of specialized theoretical and operational skills assessment decreased from 6.49% to 1.08% ( P<0.01). The number of unqualified nursing quality cases in the two groups decreased to different degrees ( P< 0.05). Among the occurrence of adverse events in the two groups, the incidence of intraoperative counting accidents decreased from 1.85% to 0 ( P<0.05), and the incidence of iatrogenic head and face stress injuries of surgical patients decreased from 2.47% to 0.31% ( P<0.05) . Conclusions:The sensitive indicator system for the quality of eye, ear, nose and throat specialized nursing in the Operating Room constructed in this study is scientifically sound and applicable, which can effectively reduce nursing risks in specialized Operating Rooms and improve the quality of nursing work in specialized Operating Rooms.

Objective:To retrospectively analyze the treatment status of tyrosine kinase inhibitors (TKI) in newly diagnosed patients with chronic myeloid leukemia (CML) in China.Methods:Data of chronic phase (CP) and accelerated phase (AP) CML patients diagnosed from January 2006 to December 2022 from 77 centers, ≥18 years old, and receiving initial imatinib, nilotinib, dasatinib or flumatinib-therapy within 6 months after diagnosis in China with complete data were retrospectively interrogated. The choice of initial TKI, current TKI medications, treatment switch and reasons, treatment responses and outcomes as well as the variables associated with them were analyzed.Results:6 893 patients in CP ( n=6 453, 93.6%) or AP ( n=440, 6.4%) receiving initial imatinib ( n=4 906, 71.2%), nilotinib ( n=1 157, 16.8%), dasatinib ( n=298, 4.3%) or flumatinib ( n=532, 7.2%) -therapy. With the median follow-up of 43 ( IQR 22-75) months, 1 581 (22.9%) patients switched TKI due to resistance ( n=1 055, 15.3%), intolerance ( n=248, 3.6%), pursuit of better efficacy ( n=168, 2.4%), economic or other reasons ( n=110, 1.6%). The frequency of switching TKI in AP patients was significantly-higher than that in CP patients (44.1% vs 21.5%, P<0.001), and more AP patients switched TKI due to resistance than CP patients (75.3% vs 66.1%, P=0.011). Multi-variable analyses showed that male, lower HGB concentration and ELTS intermediate/high-risk cohort were associated with lower cytogenetic and molecular responses rate and poor outcomes in CP patients; higher WBC count and initial the second-generation TKI treatment, the higher response rates; Ph + ACA at diagnosis, poor PFS. However, Sokal intermediate/high-risk cohort was only significantly-associated with lower CCyR and MMR rates and the poor PFS. Lower HGB concentration and larger spleen size were significantly-associated with the lower cytogenetic and molecular response rates in AP patients; initial the second-generation TKI treatment, the higher treatment response rates; lower PLT count, higher blasts and Ph + ACA, poorer TFS; Ph + ACA, poorer OS. Conclusion:At present, the vast majority of newly-diagnosed CML-CP or AP patients could benefit from TKI treatment in the long term with the good treatment responses and survival outcomes.

Objective    To define the patient characteristics and perioperative management, and to define the mortality and its risk factors after arterial switch operation (ASO). Methods    We conducted a bidirectional cohort study with 571 consecutive patients undergoing ASO from 1997 to 2016 in our hospital. We enrolled patients who underwent ASO before 2012 retrospectively and after 2012 prospectively and followed up all the patients prospectively. Demographic characteristics, clinical information and mortality of these patients were summarized. Joinpoint regression analysis was used to identify the time trend of the overall mortality. Kaplan-Meier survival analysis was used to evaluate the mid- and long-term survival rate after ASO. Cox proportional hazards regression models were used to explore the potential factors associated with mortality. The cumulative incidence of complications after ASO was predicted using competing risk models. Results    Several aspects of patients’ characteristics and perioperative management in our center differed from those in the developed countries. The overall mortality and in-hospital mortality after ASO was 16.3% and 15.1%, respectively. The overall cumulative survival rate at 5, 10 and 15 years after ASO was 83.3%, 82.8% and 82.8%, respectively. A significant decrease of overall mortality from 1997 to 2016 was observed. Independent risk factors of mortality included earlier ASO (1997-2006), single or intramural coronary anatomy and longer cardiopulmonary bypass time. Ten years after ASO, re-intervention, arrhythmia, pulmonary and anastomotic stenosis were the most common complications with a cumulative incidence over 10%. Conclusion    Significant improvements in the results of the ASO were observed and the postoperative mortality rate is close to reports from developed countries. Nonetheless, we have identified the need for further improvement in the early and late postoperative periods after ASO. Pulmonary stenosis, anastomotic stenosis and arrhythmia should be paid attention to during the long-term follow-up after ASO.