Objective To evaluate the clinical efficacy of laser-assited subepithelial keratomileusis(LASEK) for treatment of myopia and astigmatism.Methods LASEK was performed for 30 cases(60 eyes) with myopia and astigmatism.The preoperative myopia diopter ranged from -1.50DS to -11.00DS,the astigmatism ranged from -1.50DC to -2.50DC.To make corneal subepithelial valve,eyes were soaked in 20% alcohol for 30 to 35 seconds.It was applied with quasi-molecule laser system.Results The visions with 73.17% were between 0.8 and 1.0 one month post-operatively,26.55% between 0.5 and 0.7,and 0.27% less than 0.5;The average visions with 76.69% were between 0.8 and 1.0 three months post-operatively,and 23.30% between 0.5 and 0.7;The visions with 77.78% were between 0.8 and 1.0 in six months after operation,and 21.68% between 0.5 and 0.7.There were no significant difference between in three months post-operatively and preoperative in corrected visions.Conclusion LASEK induces less pain and HAZE than PRK and LASEK has wider surgery field.Moreover,the risk of LASEK has less risk and less hidden danger than LASIK.In summary,LASEK is one of the safe choices in the treatment of myopia with laser relatively.

Objective? To evaluate the incidence of upper extremity deep venous thrombosis (UEDVT) after traumatic fracture using Meta-analysis. Methods? Chinese Biomedical Science Articles Database (CBMdisc), CNKI, Wanfang Medical Network Database were searched to collect studies about UEDVT after traumatic fracture from January 1st, 1990 to December 31st, 2018. After inclusion of exclusion criteria, literature was screened according to PICO principle, and literature quality was evaluated according to STROBE declaration. Qualified literature was used to extract data on the incidence of upper limb thrombosis, and data fusion was carried out using Meta-analysis method of single-arm study. Results? Finally, 9 articles of high quality were included in the study, including 14 425 patients. Data fusion result showed that the incidence of UEDVT after upper limb fracture was 0.83% (95%CI: 0.69% - 0.98%). Axillary vein thrombosis accounted for 19.99%, brachial vein thrombosis 46.66%, subclavian vein thrombosis 6.58%, subclavian vein-brachial vein thrombosis 14.84%, axillary vein-brachial vein thrombosis 11.93% in UEDVT after upper limb fracture. The incidence of UEDVT was 1.83% after humeral surgical neck fracture and 1.76% after humeral shaft fracture. Conclusions? The overall incidence of UEDVT after upper limb fracture was 0.83%. Brachial vein and axillary vein are the main sites, which should be paid attention to in postoperative nursing. The incidence of UEDVT in patients with proximal humeral fracture and peri-shoulder fracture is higher than that in patients with other upper limb fractures, which should be paid more attention.

The safe and effective use of anticoagulants is the basis for the prevention of venous thromboembolism in elderly patients after hip fractures surgery. Postoperative general prevention, physical prevention and drug prevention should be coordinated. This article reviewed the development process of drug prevention for venous thromboembolism after hip fracture surgery in the elderly, compared the anticoagulant mechanisms and nursing points of parenteral anticoagulants, new oral anticoagulants, coumarin anticoagulants, antiplatelet aggregation drugs and oral traditional Chinese medicine prescriptions, and introduced the role of clotting time monitoring, platelet count, D-dimer, thromboelastogram, incidence of bleeding events, and gastrointestinal reactions in the monitoring of the preventive effect of venous thromboembolism drugs.

Objective? To explore the construction method and the effects of the orthopedic specialized nurse studio. Methods? The orthopedic specialized nurse studio included 4 working groups, which were intravenous therapy group, wound care group, chronic diseases management group and perioperative venous thromboembolism (VTE) management group. Each group were assigned 1 team leader and 10 to 12 team members. Nursing training, management and research were carried out. The professional competency of orthopedic nursing staff and the nursing quality were compared before (January to December 2016) and after (January to December 2017) the construction of the studio. Results? The scores of theoretical assessment, specialized nurses' performance and nursing quality in 2017 were (97.76±4.09), (82.25±6.60) and (99.06±0.91) respectively, which were higher than those of the same period in 2016. The differences were statistically significant (t=2.169, 3.327, 2.129; P＜ 0.05). Conclusions? The establish of the orthopedic specialized nurse studio can enhance the growth of specialized nursing team, improve the nursing quality and promote the development of multi-disciplinary integration.

Objective To simulate and analyze the CT examination doses to typical patients based on Chinese reference human phantom, and to develop an online software for assessing the organ absorbed dose and effective dose to the examinees undergoing CT examination in order to provide a tool for rapid assessment of radiation dose from CT examination. Methods Based on the Monte Carlo simulation, a GE LightSpeed 16 CT scanner was modeled. The organ doses to Chinese adult male, female and 1 year-old child male from single axial scan were calculated based on the Chinese reference phantoms and an organ dose database was established. A web-based CT dose assessment software was developed to read the data from the organ dose database according to the CT scanning parameters entered by the user and to calculate the organ absorbed dose and effective dose rapidly. Results A new CT dose assessment software was developed, which can be used to assess organ doses to Chinese adult male, female and 1-year-old male for different CT scanner, voltage, current, collimator width and other CT parameters. The organ doses calculated in this work were compared with simulation data in two relevant studies. Dose differences for the organs completely included in the scan range were small, with relative differences less than 15％ and 25％, respectively. Conclusions The CT dose assessment software provides a powerful tool for the simple and rapid assessment of radiation dose to the examinees undergoing CT examinations.

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.