This article reviews the health-related home safety assessment methods for the elderly, and briefly introduces the development process of the "Person-environment fit" model from the concept, to the risk assessment method of environmental factors and then to the interactive risk assessment method of human-environment factors.Especially, this article introduces several risk assessment methods of residential environment, such as "The Enabler" human function and environmental obstacle assessment tool, the Safety Assessment of Function and the Environment for Rehabilitation(SAFER), the Safety Assessment of Function and the Environment for Rehabilitation-Health Outcome Measurement and Evaluation(SAFER-HOME), the Westmead Home Safety Assessment(WeHSA), the Home Falls and Accident Screening Tool(HOME FAST), the Cougar Home Safety Assessment(CHSA), the in-Home Occupational Performance Evaluation(I-HOPE), the In-Home Occupational Performance Evaluation for Providing Assistance(I-HOPE Assist), the In-Home Medication Management Performance Evaluation(HOME-Rx).

Objective To study the optimal management of the closed-loop management in safe practice of nursing teaching in private hospitals.Method Through analyzing the causes and problems during the teaching of nursing adverse events,the closed-loop management in safe practice of nursing teaching was investigated,including the closed-loop management team,implementation cycle and range,etc.Totally 100 teachers and 220 students were chosen in 27 clinical teaching departments of our hospital during January 2013 and March 2014.The teachers were divided into experimental group (n=50) and the control group (n=50).The closed-loop management model was applied in experimental group while routing management was applied in control group.At the same time,220 students' behavior in experimental group was compared before and after the closed-loop management.Through the evaluation of nursing teaching' safe hidden trouble and questionnaire survey,the nursing teaching of both groups were safe.SAS 9.2 was applied to do statistical analysis and non-parametric Wilcoxon Fisher exact test and x2 test were used.Results The number of teachers' operating key points in experimental group was significantly higher than the control group,with statistically significant differences (46 vs.15) (P=0.000).The safety hazard times of nursing teaching were 38 and 8 respectively before and after the closed loop management,and the difference was statistically significant (P=0.000).In addition,the comparison before the students' implementing the check system,hospital safety index patients and regulation for technical operations and hospital infection was significant after the closedloop management (P＜0.01 for all).Conclusion The full implementation of the closed-loop management,effective tracking and prevention in place,can optimize the safety management of nursing teaching.

Objective To evaluate the accuracy of Intraoperative Iso-C3D navigation guiding cervical pedicle screw fixation. Methods Twenty-two cases adopted cervical pedicle screw fixation of cervical spine, including 9 cervical spine fractures, 4 cervical tumors, 6 cervical destabilizing, 3 cervical syndrome. The cervical pedicle screw position were assessed with post-operative CT by grade. Results One hundred and twelve screws were fixed in 22 cases successfully. Grade: 107 in A grade (95.5%); 3 in B grade: 1 in C grade; 1 in D grade. There were not any complication. Conclusion Intraoperative Iso-C3D navigation can improve precision of cervical petiole screw fixation distinctively.

Objective To understand the mental health status between left‐behind children and un‐left‐behind children during primary school period in Yongchuan district of Chongqing city ,and to provide the theoretical basis for the study of the left‐behind children children′s mental problems and formulating the strategy and measures for preventing their psychological problems .Methods The Mental Health Rate Scale for Pupil (M HRSP) was used to evaluate the mental health condition in 4 987 primary school pu‐pils from 4 primary schools in Yongcuan discrict ,including 3 482 un‐left‐behind children(69 .82% ) and 1 505 left‐behind children (30 .18% ) .Results Totally 4 753 effective questionnaires were taken back with the effective rate of 95 .31% .The detection rate of total score deviation in left‐behind children was 13 .98% ,which was significantly higher than in un‐left‐behind children(6 .33% ) . The deviation detection rate of learning disabilities in left‐behind children was 14 .90% ,emotional disorder was 16 .81% ,character flaw was 12 .36% ,social adjustment disorder was 13 .91% ,moral defect was 14 .27% ,bad habits was 15 .61% ,behavior disorder rate was 16 .53% and the special obstacles was 11 .72% .Compared with un‐left‐behind children ,excluding the character flaw ,social adjustment and moral defect ,the deviation detection rate and scores of other 5 items in left‐behind children were higher than those in un‐left‐behind children .The scores of learning disabilities ,emotional disorder and bad habits in male pupils were higher than those in female pupils with statistical difference(P< 0 .05) .The scores of learning disabilities ,emotional disorder ,character flaw and behavior disorder in the high grade pupils were higher than those in the low grade pupils ,the differences were statistically sig‐nificant(P<0 .05) .Conclusion The mental health level of rural left‐behind children in Yongchuan district is low ,the problems are more serious compared with un‐left‐behind children .In carrying out the mental health education work in primary school pupils ,es‐pecially the mental health education should be paid attention to rural left‐behind children ,moreover the mental health education should be carried out aiming at different ages and different genders .

OBJECTIVE:To provide references for rational use of human serum albumin.METHODS:The inpatients receiving human serum albumin in the hospital during Jan.-Dec.2014 were investigated retrospectively and analyzed in respects of general information of patients,serum albumin level before medication,drug dosage,drug cost and reasons.RESULTS:Eight thousand seven hundred and sixty patients from top 8 departments in the list of the number of patients of human serum albumin were included in the study,accounting for 64％ of total.There were 5 244 male (59.9％) and 3 516 female (40.1％);patient's age mainly ranged ＞ 30-60 year-old (52.6％).The number of patients of albumin was the largest in general surgery department (2 588 cases) and cardio vascular surgery department (2 348 cases).Referring to domestic package inserts,8 210 patients (about 93.7％) were in accor dance with indications,and hypoproteinemia was the most common medication indication (35.6 ％).The drug dosage per capita of ICU was the highest (152.5 g);total drug cost was the highest in general surgery department (13 334 396.4 yuan);treatment course per capita of infection disease department was the longest (10.7 d).CONCLUSION:There is irrational use of human serum albumin in our hospital and difference of drug use among departments.It is necessary to strengthen human serum albumin use monitoring and establish rational medication evaluation system so as to promote standard drug use and realize rational distribution of medical resources.

Objective To explore the effects of Tongyuan acupuncture combined with herbal medicine and moxibustion on the behavior and hypothalamic-pituitary-adrenal axis-related hormone levels in postpartum de-pression rats.To explore the therapeutic mechanism of this method in the treatment of postpartum depression.Meth-ods A total of 120 SD rats were randomly divided into 6 groups(n=20).The blank group was not treated.The sham operation group was performed without surgery to remove the ovaries. The model group,drug group,routine acupuncture group and experimental group were established in the model of postpartum depression.After modeling successfully,the model group did not interfere with any treatment. The rats in treatment group were treated with fluoxetine hydrochloride. The acupuncture group was treated with acupuncture of Baihui and Taichong. The rats in the experimental group were treated with the method of acupuncture and moxibustion.At the end of the second and fourth week after the initiation of intervention,10 rats were randomly selected from each group.They were sacrificed and the levels of serum corticotropin-releasing hormone(CRH),adrenocorticotropic hormone(ACTH),cortisol (Cor)were measured.Results The levels of CRH,ACTH and Cor in the model group were higher than those in the blank group(P<0.05).The levels of serum CRH,ACTH and Cor in the drug group,routine acupuncture group and experimental group were lower than those in the model group(P<0.05).The levels of serum ACTH and Cor in the experimental group were lower than those in the drug group and routine acupuncture group(P<0.05).There was no significant difference in serum CRH,ACTH and Cor level between the experimental group and blank group(P >0.05).Conclusions Tongyuan acupuncture combined with salt moxibustion and Shenque have significant effects on the depressive symptoms and serum levels of CRH,ACTH and Cor in postpartum depression rats,which may be re-lated to the regulation of hypothalamic-pituitary-adrenal axis-related hormone levels.

OBJECTIVETo investigate in vivo survival of retinal ganglion cells (RGCs) after partial blockage of optic nerve (ON) axoplasmic flow by sub-retinal space or vitreous cavity injection of brain-derived neural factor (BDNF) produced by genetically modified neural progenitor cells (NPCs).

METHODSAdult Sprague-Dawley (SD) rat RGCs were labeled with granular blue (GB) applied to their main targets in the brain. Seven days later, the left ON was intra-obitally crushed with a 40 g power forceps to partially block ON axoplasmic flow. Animals were randomized to three groups. The left eye of each rat received a sham injection, NPCs injection or an injection of genetically modified neural progenitors producing BDNF (BDNF-NPCs). Seven, 15 and 30 days after ON crush, retinas were examined under a fluorescence microscope. By calculating and comparing the average RGCs densities and RGC apoptosis density, RGC survival was estimated and the neuro-protective effect of transplanted cells was evaluated.

RESULTSSeven, 15 and 30 days after crush, in the intra-vitreous injection group, mean RGC densities had decreased to 1885 +/- 68, 1562 +/- 20, 1380 +/- 7 and 1837 +/- 46, 1561 +/- 58, 1370 +/- 16, respectively with sham injection or neural progenitors injection. However, RGCs density in the groups treated with intra-vitreous injection of BDNF-NPC was 2101 +/- 15, 1809 +/- 19 and 1625 +/- 34. Similar results were found in groups after sub-retinal injection. Higher densities were observed in groups treated with BDNF-NPCs. There were statistically significant differences among groups through nonparametric tests followed by the Mann-Whitely test. RGC apoptosis density in BDNF-NPC at each follow-up time was less than in other groups.

CONCLUSIONSA continuous supply of neurotrophic factors by the injection of genetically modified neural progenitors presents a highly effective approach to counteract optic neuropathy and RGC degeneration after partial ON axoplasmic flow blockage.

Animals ; Apoptosis ; Axonal Transport ; Brain-Derived Neurotrophic Factor ; genetics ; Cell Survival ; Gene Transfer Techniques ; Genetic Therapy ; Glaucoma ; therapy ; Male ; Rats ; Rats, Sprague-Dawley ; Retinal Ganglion Cells ; cytology ; Stem Cells ; physiology ; Vitreous Body ; metabolism

Objective To compare the clinical efficacy of external fixator and locking plate internal fixation via middle volar minimally invasive approach in the treatment of distal radius fractures.Methods A retrospective case-control study was conducted on the clinical data of 51 patients with distal radius fractures admitted from October 2014 to August 2016.There were 21 males and 30 females,aged 41-78 years (mean,57 years).According to the random number table method,the patients were divided into minimally invasive plate group (25 cases) which adopted locking plate internal fixation via middle volar minimally invasive approach and external fixator group (26 cases) with closed reduction of external fixator.The AO classification of the fractures in minimally invasive plate group was as follows:A2 in four cases,A3 in five cases,B1 in four cases,B2 in two cases,B3 in seven cases,and C1 in three cases.The AO classification of the fractures in external fixator group was as follows:A2 in three cases,A3 in six cases,B1 in five cases,B2 in three cases,B3 in seven cases,and C1 in two cases.The total incision length,operation time,intraoperative blood loss,preoperative and postoperative radial height,palmar inclination angle,ulnar deviation angle,pain visual analogue score (VAS),wrist active motion range (palmar flexion,dorsal extension,pronation,supination,radial deviation,and ulnar deviation),relative contralateral grip force,and wrist function Mayo score were compared between the two groups.Results There were no significant differences in the total length of incision,operation time,intraoperative blood loss,VAS 3 d after operation,radius height,ulnar deviation,and radius height,palm inclination and ulnar deviation at 14 months after operation between the two groups (P ＞ 0.05).The palmar inclination was (9.6-± 0.6) ° in the minimally invasive plate group and (7.9 ± 0.6) ° in the external fixator group (P ＜ 0.05).The wrist active motion range (palmar flexion,dorsal extension,pronation,supination,radial deviation,and ulnar deviation) and relative contralateral grip strength 3 months after operation in the minimally invasive plate group were significantly better than those in the external fixator group (P ＜ 0.05).However,the Mayo score of wrist function at 14 months after operation was (88.7 ± 12.7)points in the minimally invasive plate group and (88.7 ± 13.1)points in the external fixator group (P ＞ 0.05).Minimally invasive plate group showed median nerve stimulation in one case.External fixator group showed redness around the nail,increased temperature,and increase secretion of the infection in one case,and joint stiffness in one case after external fixation removal.But all symptoms were improved or resolved after treatment.Conclusion Both locking plate via minimally invasive approach and external fixator can achieve good results in the treatment of distal radius fractures,but the former method has better effects on early functional recovery than the latter one.

Objective:To investigate the surgical effect of pedicled upper lip mucosal flap in repairing nasal septal mucosal defects after rhinoplasty.Methods:A retrospective analysis was performed from January 2016 to October 2022, the clinical data of patients with nasal septal mucosal defects after rhinoplasty were collected in the Department of Plastic and Aesthetic (Burn) Surgery at the Second Xiangya Hospital of Central South University. The pedicled upper lip mucosal flap was utilized for repair based on the patient’s medical history and wound condition. The pedicle of the flap was designed 1 cm adjacent to the frenulum of the upper lip, and an appropriate flap was incised based on the size of the wound, with dissection performed up to the superficial layer of the orbicularis oris muscle. The dissection establishes an upper lip tunnel that connects the gingival-buccal groove to the nasal cavity. The pedicled upper lip mucosal flap was elevated and transposed into the nasal cavity via the upper lip tunnel. The position of the flap was adjusted to ensure complete coverage and fixation of the nasal septal defect wound using 5-0 absorbable suture. The visual analogue scale (VAS) and the nasal obstruction symptom evaluation (NOSE) scale were utilized to facilitate patients’ satisfaction evaluation and assessment of nasal obstruction symptoms before surgery and at 6 months post-surgery. The VAS total score was 10 points, with higher scores indicating greater levels of patient satisfaction. The NOSE scale comprises of 5 items, each assigned a score ranging from 0 to 4, denoting absence of symptoms, very mild presence, moderate intensity, relatively severe manifestation, and highly severe indication respectively. The measurement data of VAS and NOSE scores before surgery and at 6 months post-surgery was expressed by Mean±SD, using paired t-test. The score distribution of the NOSE scale was represented by the number of cases, using Mann-Whitney U test. Results:The study included a total of 15 female patients, with an average age of (27.6±2.9) years (ranging from 23 to 33 years). Eleven cases presented with preoperative cartilage exposure, and the size of tissue defect ranged from 0.9 cm×0.5 cm to 1.5 cm×0.7 cm. Nine patients had a history of smoking. Skin grafting was performed in 9 patients, while nasal mucosal metastasis was observed in 8 patients. The dimensions of the flap varied from 4.0 cm×1.2 cm to 7.0 cm×1.5 cm. The postoperative recovery was satisfactory, with successful survival of the skin flaps and no occurrences of infection, hematoma, wound dehiscence, or flap necrosis. The average duration of follow-up was (8.2±2.1) months (ranging from 6 to 12 months). The postoperative VAS score (7.73±0.88) was significantly higher compared to the preoperative score (1.86±0.74) ( P<0.01). Additionally, the postoperative NOSE score (4.66±1.71) showed a significant decrease from the preoperative score (10.73±2.68), with a statistically significant difference ( P<0.01). Among them, after surgery items of stuffy or unbreathable nose (2 cases vs. 15 cases), nasal obstruction (1 case vs. 14 cases), and feeling that the nose was not enough to breathe during exercise or exertion (4 cases vs. 14 cases) scored≥2 points were significantly less than those before operation (all P<0.01). Conclusion:The utilization of pedicled upper lip mucosal flap in the reconstruction of severe nasal septal mucosal defects following rhinoplasty has proven to be highly effective. The postoperative satisfaction of patients is remarkably high, the ventilation function exhibits significant improvement, and no severe complications are observed.

Objective:To investigate the surgical effect of pedicled upper lip mucosal flap in repairing nasal septal mucosal defects after rhinoplasty.Methods:A retrospective analysis was performed from January 2016 to October 2022, the clinical data of patients with nasal septal mucosal defects after rhinoplasty were collected in the Department of Plastic and Aesthetic (Burn) Surgery at the Second Xiangya Hospital of Central South University. The pedicled upper lip mucosal flap was utilized for repair based on the patient’s medical history and wound condition. The pedicle of the flap was designed 1 cm adjacent to the frenulum of the upper lip, and an appropriate flap was incised based on the size of the wound, with dissection performed up to the superficial layer of the orbicularis oris muscle. The dissection establishes an upper lip tunnel that connects the gingival-buccal groove to the nasal cavity. The pedicled upper lip mucosal flap was elevated and transposed into the nasal cavity via the upper lip tunnel. The position of the flap was adjusted to ensure complete coverage and fixation of the nasal septal defect wound using 5-0 absorbable suture. The visual analogue scale (VAS) and the nasal obstruction symptom evaluation (NOSE) scale were utilized to facilitate patients’ satisfaction evaluation and assessment of nasal obstruction symptoms before surgery and at 6 months post-surgery. The VAS total score was 10 points, with higher scores indicating greater levels of patient satisfaction. The NOSE scale comprises of 5 items, each assigned a score ranging from 0 to 4, denoting absence of symptoms, very mild presence, moderate intensity, relatively severe manifestation, and highly severe indication respectively. The measurement data of VAS and NOSE scores before surgery and at 6 months post-surgery was expressed by Mean±SD, using paired t-test. The score distribution of the NOSE scale was represented by the number of cases, using Mann-Whitney U test. Results:The study included a total of 15 female patients, with an average age of (27.6±2.9) years (ranging from 23 to 33 years). Eleven cases presented with preoperative cartilage exposure, and the size of tissue defect ranged from 0.9 cm×0.5 cm to 1.5 cm×0.7 cm. Nine patients had a history of smoking. Skin grafting was performed in 9 patients, while nasal mucosal metastasis was observed in 8 patients. The dimensions of the flap varied from 4.0 cm×1.2 cm to 7.0 cm×1.5 cm. The postoperative recovery was satisfactory, with successful survival of the skin flaps and no occurrences of infection, hematoma, wound dehiscence, or flap necrosis. The average duration of follow-up was (8.2±2.1) months (ranging from 6 to 12 months). The postoperative VAS score (7.73±0.88) was significantly higher compared to the preoperative score (1.86±0.74) ( P<0.01). Additionally, the postoperative NOSE score (4.66±1.71) showed a significant decrease from the preoperative score (10.73±2.68), with a statistically significant difference ( P<0.01). Among them, after surgery items of stuffy or unbreathable nose (2 cases vs. 15 cases), nasal obstruction (1 case vs. 14 cases), and feeling that the nose was not enough to breathe during exercise or exertion (4 cases vs. 14 cases) scored≥2 points were significantly less than those before operation (all P<0.01). Conclusion:The utilization of pedicled upper lip mucosal flap in the reconstruction of severe nasal septal mucosal defects following rhinoplasty has proven to be highly effective. The postoperative satisfaction of patients is remarkably high, the ventilation function exhibits significant improvement, and no severe complications are observed.