Objective: To explore the feasibility and clinical effect of single bundle anatomic intrathecal reconstruction of proximal injury of anterior cruciate ligament (ACL) using dissociate peroneus longus tendon combined with semitendinosus tendon. Methods: From January 2015 to September 2016, a total of 24 patients with proximal injury of ACL, confirmed by arthroscopy, were admitted to the sports medicine department of our hospital. The ACL was completely ruptured from the proximal footprint and the tibial side residual remained intact. There were 19 males and 5 females; 16 cases on the right side and 8 cases on the left side. The mean age was 27.88±7.13 years old; The interval between injury and surgery was 14.83±9.09 d; The dissociate peroneus longus tendon and semitendinosus tendonfrom the injured extremity were folded in half, then braided and trimmed into ACL graft for use. The ACL remnant was preserved and the graft was pulled through the stump for single bundle anatomic intrathecal reconstruction. The ACL graft was fixed with Endobutton on the femoral side and interference screw on the tibial side. The results of Lachman test, Lysholm scores, Tegner scores and International Knee Documentation Committee (IKDC) subjective scores of knee before operation and at final visit were recorded to evaluate the stability and function of the knee. Visual analogue score (VAS) was used to record the changes of pain at the site where the peroneal longus tendon was harvested. The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scores were recorded before injury and at the final visit to assess the effect of ankle function after peroneal longus tendon resection. Results: The diameter of the ACL graft made of dissociate peroneus longus tendon and semitendinosus tendon is 8.88±0.30 mm. All patients were followed up at the outpatient clinic, with an average of 34.38±5.40 months, and no serious complications such as rerupture and joint infection were found. There were 16 grade B, 6 grade C and 2 grade D for preoperative Lachman test, none with hard end point. At last vist, there were 23 cases of grade A and 1 grade B, all with hard end points for Lachman test. At the preoperative and final visit, the Lysholm scores of the knee joint were 35.20±11.92 and 94.29±2.92 (t=23.850, P=0.000). Tegner scores were 3.46±0.93 and 8.04±1.00 (t=16.653, P=0.000). The subjective IKDC scores of knee joint were 47.63±13.06 and 91.71±3.75 (t=15.972, P=0.000). At the final visit, all the indicators of the knee were improved compared with those before surgery, and the difference was statistically significant.The AOFAS scores before injury and at the final visit were 98.83 (2.78) and 98.17 (4.01), respectively, with no statistically significant difference (t=1.850, P=0.076) . The VAS scores for the harvest of theperoneus longus tendon were 4.50±1.41, 0.54±0.65 and 0.29±0.55 immediately and 6 months after the operation and at the last visit.There was statistically significant difference between the scores immediately and 6 months after the operation (t=14.900, P=0.001).There was statistically significant differences between the scores at 6 months after the operation and the final visit (t=2.770, P=0.011). Conclusion Single bundle anatomic intrathecal reconstruction of proximal injury of ACL using dissociate peroneus longus tendon and semitendinosus tendon is feasible with good clinical effect.

Objective:To investigate clinical characteristics and potential risk factors of very preterm/very low birth weight infants with bronchopulmonary dysplasia (BPD).Methods:A retrospective epidemiological study was performed in 341 neonates with birth weights<1 500 g or gestational age between 23 + 0 to 31 + 6 weeks, who were born in Foshan Women and Children Hospital and were admitted to neonatal intensive care units (NICU) within 24 hours of birth. These neonates were divided into non-BPD group and BPD group. Clinical characteristics and potential risk factors were comparatively analyzed between groups. Risk factors for BPD were identified by binary logistic regression analysis. Results:Among the total of 341 enrolled neonates, including 255 neonates without BPD and 86 neonates with BPD, the total incidence of BPD was 25.2%. The incidences of BPD in the infants with gestational age of <30 weeks, 30-32 weeks, and >32 weeks, as well as birth weight <1 000 g, 1 000-1 499 g, and ≥1 500 g were 43.8%(63/144), 15.1%(22/146), 2.0%(1/51), 80.0%(36/45), 20.2%(41/203), 9.7%(9/93), respectively. The gestational age, birth weight, the proportion of cesarean section, and extubation rate within 7 days were lower in BPD group than those in non-BPD group [(28.5±2.4)weeks vs (30.7±1.8)weeks, (1 087.9±312.8)g vs (1 418.4±247.9)g, 54.6%(47/86) vs 75.7%(193/255), 57.1%(44/77) vs 90.0%(108/120), all P<0.05]. Compared to the non-BPD group, the proportion of Apgar score of ≤7 points 5 minutes after birth [16.3%(14/86) vs 2.4%(6/255)], postnatal endotracheal intubation rate [62.8%(54/86) vs 27.4%(70/255)], volume of red blood cell transfusion ≥3 times [31.4%(27/86) vs 6.3%(16/255)], pulmonary surfactant (PS) utilization [82.6%(71/86) vs 44.7%(114/255)], rate of conventional mechanical ventilation [89.5%(77/86) vs 47.0%(120/255)], combined with hemodynamically significant patent ductus arteriosus (HsPDA) [34.9%(30/86) vs 8.2%(21/255)], diagnosed with neonatal respiratory distress syndrome (NRDS) [94.2%(81/86) vs 5.9%(15/255)], combined with clinically diagnosed sepsis [17.4%(15/86) vs 7.0%(18/255)], combined with ≥3 stage retinopathy of prematurity (ROP) [20.9%(18/86) vs 2.7%(7/255)] and mortality [10.5%(9/86) vs 0.8%(2/255)], length of conventional mechanical ventilation, duration of oxygen consumption, and length of hospital stays were higher in the BPD group (all P<0.05). The results of multivariate logistic regression analysis showed that small gestational age ( OR=1.285, 95% CI: 1.010-1.633), Apgar score ≤7 points within 5 min of birth ( OR=5.712, 95% CI: 1.411-23.115), mechanical ventilation duration ( OR=1.113, 95% CI: 1.043-1.188) and oxygen duration ( OR=1.139, 95% CI: 1.092-1.188) were high risk factors for the development of BPD, while heavier birth weight ( OR=0.996, 95% CI: 0.994-0.998) was protective factor for BPD. Conclusions:The smaller the gestational age and the lower the birth weight, the higher the incidence of BPD, Apgar score≤7 points within 5 min of birth, long conventional mechanical ventilation time, and long duration of oxygen consumption are the risk factors for BPD. Prevention of premature delivery, reduction of asphyxia at birth, reduction of endotracheal intubation and invasive ventilation duration, and reduction of oxygen use time are effective measures to reduce the occurrence of BPD.

Objective:To summarize the best evidence of intracranial hypertension nursing for adult patients with severe brain injury, and to provide reference for clinical nursing practice.Methods:According to the evidence-based methodology, a systematic search of Chinese and English literature on intracranial hypertension nursing of adult patients with severe brain injury was conducted in domestic and foreign databases such as CNKI, Wanfang, PubMed, Cochrane Library and Cinahl Plus and so on, as well as related guide websites and professional association websites from the establishment of database to August 2022. Two researchers independently evaluated literature quality and screened evidence, and then the project team summarized and concluded the evidence.Results:A total of 6 009 articles were obtained through preliminary search, and 33 articles were included after screening, including 13 guidelines, 1 systematic review, 17 expert consensus, 1 evidence summary, and 1 meta-analysis. In total, 33 pieces of best evidence were obtained from 8 dimensions, including intracranial pressure related threshold, assessment and monitoring, respiratory care, circulation care, analgesic and sedative care, temperature care, nutrition care and cerebrospinal fluid care.Conclusions:This study summarizes the evidence-based basis of intracranial hypertension nursing in adult patients with severe brain injury, which provides a basis for the standardized construction of clinical nursing strategies and empirical research.

The pharmacy of Y anqing Winter （Paralympic）Olympic Village Polyclinic of 2022 Beijing Winter （Paralympic） Olympic Games will be comprehensively managed from five aspects of man ，machine，material，method and environment by adopting the 4M1E management method of quality management tool . In terms of man ，constantly enhanced training and daily health monitoring have been insisted ；in terms of machine ，drug information entry and drug information management have been improved and maintained ；in terms of drugs ，on the basis of drug management ，the management of drugs banned by the World Anti -Doping Agency，class Ⅱ psychotropic drugs and narcotic drugs have been strengthened ；in terms of regulations and environment ，strict pharmacy workflow and management system have been established ，and epidemic prevention closed -loop management requirements have been strictly implemented . From the pre -opening of Yanqing Winter （Paralympic）Olympic Village on January 23，2022 to the official closing of the Village on March 16，2022，the clinic pharmacy dispensed a total of 156 prescriptions（105 prescriptions during the Winter Olympic Games ，51 prescriptions during the Winter Paralympic Games ），including 18 prescriptions from the National （Regional） Olympic Committee and the National （Regional） Paralympic Games team doctors ，2 prescriptions containing stimulants that do not need to be exempted from treatment，1 prescription for narcotics ，and 37 prescriptions for athletes（23.7%）. Ibuprofen tablets ，Diclofenac diethylamine emulsion，Loratadine tablets and other drugs are widely used . The application of 4M1E management method enables the clinic pharmacy to provide perfect and high -quality pharmaceutical services for large -scale events while doing well in epidemic prevention and control .