Objective To study the application of remifentanil combined with brachial plexus block using in the operation of children with upper limb.Methods A total of 40 children,aged 4～10 years,undergoing arm-fracture operation,breathing oxygen with opening veil,were randomly divided into two groups.The children were administered basal anesthesia before brachial plexus block.During the operation,the study group(n=20)was infused remifentanil，the initial rate was 0.05μg·kg-1·min-1，and the control group was infused ketamine to reinforce the analgesia.Results All patients finished the surgery safely.In study group,children recovery time[(14.0±4.8)min]Was more quickly than that of control group[(30.4±10.3)min](t=6.5 88,P＜0.01).Conclusion Remifentanil could efficiently assistant brachial plexus block in the operation of children with upper limb.

Mechanical properties and biological evaluation of buffalo horn material were examined in this study. The effects of sampling position of buffalo horn on mechanical properties were investigated with uniaxial tension and micron indentation tests. Meanwhile, the variation of element contents in different parts of buffalo horn was determined with elemental analysis, and the microstructure of the horn was measured with scanning electron microscopy. In addition, biological evaluation of buffalo horn was studied with hemolytic test, erythrocyte morphology, platelet and erythrocyte count, and implantation into mouse. Results showed that the buffalo horn had good mechanical properties and mechanical characteristic values of it gradually increased along with the growth direction of the horn, which may be closely related to its microstructure and element content of C, N, and S in different parts of the buffalo horn. On the other hand, because the buffalo horn does not have toxicity, it therefore does not cause hemolysis of erythrocyte and has a good affinity with it. Buffalo horn has good histocompatibility but meanwhile it may induce the platelet adhesion and aggregation. Even so, it does not continue to rise to induce a large number of platelet to aggregate with resulting blood clotting. Therefore, the buffalo horn material has been proved to possess good blood compatibility according to the preliminary evaluation.
Animals ; Biocompatible Materials ; Biomechanical Phenomena ; Buffaloes ; Erythrocytes ; Horns ; chemistry ; ultrastructure ; Mice ; Microscopy, Electron, Scanning

Objective: To construct evaluation index system of nursing quality in day operation center and to provide the basis for scientific and objective evaluation of nursing quality in day operation center. Methods: Based on Donabedian quality model as the theoretical framework, the evaluation index system of nursing quality in day operation center was constructed by applying literature research, process tracking, hierarchical analysis and Delphi expert letter. Results: The recovery rate of RR for two rounds of questionnaire was 94.12% and 100.00%. The expert authority coefficient Cr values were 0.816/0.857 respectively. The W value of the coordination coefficient was 0.335/0.381, both of which were statistically significant (P < 0.01). Finally, an evaluation index system of quality of assisted fertility treatment care with 3 dimensions, 12 secondary indicators and 48 items was formed. Yaaph software was used to determine the weight coefficients of primary and secondary indicators, and the consistency test (CR<0.1) was performed, and the variation coefficients of all tertiary items were <0.17. Conclusion The weight distribution of the nursing quality index system in day operation center is reasonable, the index entry is clear, and it is scientific and practical.

Objective:To establish a prediction model for symptomatic radiation pneumonitis (SRP) after radiotherapy for thoracic cancer based on a longitudinal cohort and dose interval variations.Methods:Clinical data of 587 patients who received thoracic radiotherapy in Department of Radiotherapy of Yunnan Cancer Hospital from July 2022 to June 2023 were retrospectively analyzed. The National Cancer Institute common terminology criteria for adverse events (CTCAE) version 5.0 was used to grade radiation pneumonitis, and clinical factors, traditional independent dosimetric characteristics and dose interval variation characteristics were collected. Features used to predict the occurrence of SRP were screened using genetic algorithms and analyzed the correlation between the selected features and SRP occurrence. Predictive models for SRP occurrence were established using the selected features and evaluated, and the optimal predictive model was visualized using a column chart.Results:The incidence of SRP was 35.94%. Five clinical factors, seven independent dosimetric features and six dose interval variation features were screened out by genetic algorithms to effectively predict the occurrence of SRP. The area under ROC curve (AUC) of clinical factors combined with traditional independent dosimetric factors and dose interval variation factors was 76%. The AUC of clinical factors combined with traditional independent dosimetric factors and that of clinical factors combined with dose interval variation factors was 69% and 67%, respectively. The addition of the characteristics of dose interval variation factors significantly improved the effectiveness of the prediction model.Conclusions:The supplement of the characteristics of dose interval variation factors can significantly improve the performance of the SRP prediction model for thoracic tumors after radiotherapy. The SRP prediction model based on dose interval variations can effectively predict the occurrence of SRP.