Due to diminished self-immunity and oral self-cleaning ability,critically ill patients experience a significant increase in the risk of oral infection.These infections can lead to complications that not only extend hospital stays but also raise mortality.Effective oral care is very important in reducing the occurrence of such infection.Traditional method of using cotton balls in oral care are less effective and can damage the fragile oral mucosa with tweezers.Currently,clinical use of suction toothbrush needs the help of syringe or infusion device.To address these issues,we have designed a multi-functional flushing toothbrush and have obtained the National Utility Model Patent of China(ZL 2021 2 1584512.9).The toothbrush is composed of a brush head,a brush rod,a brush handle,and a water storage mechanism.The side of the toothbrush is provided with a suction tube,a water storage bag and a water guide pipe,and a one-way valve with an open direction to the right is arranged in the guide pipe and the suction pipe,medical staff can control the suction and discharge of liquid by squeezing the water storage bag,thus reducing the use of consumables such as syringes or infusion devices.The device is designed for one-handed operation,making it convenient for medical staff.The brush handle is made of transparent material,allowing medical staff to observe the color and properties of mouthwash and deal with abnormal situations in time,thereby improving safety.The material is mainly made of silicone,natural rubber and plastic,which is green and can be used repeatedly.This device has a certain practical value and is worth popularizing in clinical practice.

Objective To analyze the present situation of the preoperative visit for percutaneous coronary intervention (PCI) patients at home and abroad,and provide the reference for the preoperative visit of percutaneous coronary intervention in China. Methods We searched PubMed,Embase,Web of Science,CNKI,WanFangData,VIP,and CBM database by the computer.Then the articles for up to December 2017 which in accordance with inclusion criteria were analyzed by descriptive analysis. Results A total of 25 papers were included from 1983 to 2016, which had involved 8 articles in English and 17 in Chinese.The study of abroad began in 1983,and in China the first was in 2004.From 2008, the number of literatures were uptrend.The contents of the study were mainly about demand survey,current situation analysis,technology and effect evaluation,which the largest number of PCI visit was the aspect of effect evaluation,accounting for 68％ (17/25) of the total literature. Conclusion There is a high requirement for PCI information before the operation, but there is lack of unified standard content and process for PCI visits both at home and abroad.It is important measures to strengthen the training of specialized nurses for cardiovascular intervention and formulate standardization content and procedure of preoperative visit in order to development and further improvement of preoperative visit.

Objective:To systematically review the application of prone position ventilation in pediatric patients with hypoxemia following extracorporeal cardiac surgery.Methods:A scoping review methodology was adopted. Databases including PubMed, Embase, Web of Science, Cochrane Library, CINHAL, CBM, CNKI, Wanfang, and VIP were searched for relevant studies on the use of prone position ventilation in pediatric patients post-extracorporeal cardiac surgery. The search was conducted from the establishment of the databases until August 31, 2022. After literature screening and data extraction, research results were summarized.Results:Nine studies were ultimately included. Intervening factors in the application process of prone position ventilation included intervention timing, head-of-bed elevation angle, frequency and duration, and pediatric patient positioning. All nine studies reported positive outcomes; three articles reported associated complications.Conclusions:The timing of intervention, the angle of head-of-bed elevation, frequency and duration, patient positioning of prone position ventilation in pediatric patients with hypoxemia after extracorporeal cardiac surgery have not yet been standardized. Future high-quality research is required to further explore these intervention factors, offering references for the standardized and effective clinical application of prone position ventilation.

Objective:To compare percutaneous cannulated screw (PCS) fixation and plating via a minimally invasive longitudinal approach (MILA) after closed reduction for the treatment of intra-articular tongue-type calcaneal fractures.Methods:A retrospective analysis was conducted of the 67 patients with intra-articular tongue-type calcaneal fracture who had been treated at Department of Orthopedics, The Third Hospital of Peking University from May 2017 to May 2020. They were 56 males and 11 females, 19 to 58 years of age (average, 34.5 years). Of them, 32 were treated by the PCS fixation after closed reduction (PCS group) and 35 by the MILA plating after closed reduction (MILA group). The operation time, preoperative time, post-operative hospital stay, blood loss and postoperative complications were recorded and compared between the 2 groups. The calcaneal length, width and height, Gissane angle, B?hler angle, varus angle, valgus angle and visual analog scale (VAS) were compared between the 2 groups at preoperation, immediate postoperation, 3 months postoperation, and the last follow-up. The American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score was used at 3 months postoperation and the last follow-up to evaluate the function of the injured hindfoot.Results:There was no significant difference in the preoperative general data between the PCS group and the MILA group, showing they were comparable ( P>0.05). All patients were followed up for an average of 18.5 months (from 15 to 25 months). For the PCS group and the MILA group, respectively, the operation time was 60.5 (51.5, 68.0) min and 86.0 (78.0, 96.0) min, the blood loss 10 (5.0, 20.0) mL and 20 (15, 25) mL, the postoperative hospital stay 1 (1.0, 1.8) d and 2 (2, 3) d, the calcaneal width at immediate postoperation (43.8±4.4) mm and (40.6±2.8) mm, the calcaneal width at 3 months postoperation 43.8 (39.6, 48.3) mm and 41.5 (38.8, 44.5) mm, the calcaneal width at the last follow-up 44.2 (40.2, 48.0) mm and 41.3 (39.0, 44.3) mm, the VAS at the last follow-up 5.0 (5.0, 5.0) and 6.0 (5.0, 6.0). The comparisons of the above items showed significant differences between the 2 groups (all P<0.05). No significant differences were observed between the 2 groups in the calcaneal length or height, Gissane or B?hler angle, AOFAS hindfoot score, or complication rate (all P>0.05). Conclusions:In the treatment of tongue-type calcaneal fractures, after closed reduction, the PCS fixation can shorten operation time and postoperative hospital stay, and reduce intraoperative blood loss and postoperative pain, but the MILA plating is more advantageous in restoring the calcaneal width.

Objective:To explore the clinical effect of multidisciplinary cooperative intervention in improving self-management and improving fluid retention in the elderly patients with chronic heart failure.Methods:Totally 130 cases of the elderly patients with chronic heart failure from January to December 2018 were enrolled and were divided into control group and observation group with 65 cases randomly. The control group received routine nursing instruction and telephone follow-up. The observation group was given multidisciplinary team guidance to patients self-management in addition to routine nursing instruction and telephone follow-up. After 3 months, the self-management and fluid retention of the two groups were compared.Results:After 3 months of intervention, the scores and total scores of the observation group in the four dimensions of drug management, diet management, psychological and social adaptation management, symptom management were 19.43±0.71,11.51±0.59,19.07±0.65,25.24±1.31, 72.65±7.16, the control group was 11.09±3.40, 6.05±1.71, 12.73±2.49, 15.72±4.18, 46.35±7.83. The scores and total scores of the observation group were better than those of the control group ( t value was 4.835-13.727, all P < 0.05).After intervention for 3 months, the proportion of severe edema, moderate edema and mild edema in the observation group was 4.61% (3/65), 13.85% (9/65), 81.54% (53/65), respectively, and the control group was 38.46% (25/65), 52.31% (34/65) and 9.23% (6/65) respectively. The degree of fluid retention in the observation group was better than that in the control group ( Z value was -2.373, all P < 0.05). Conclusion:Multidisciplinary cooperative intervention can improve self-management and improve fluid retention in elderly patients with chronic heart failure.

Objective To explore the efficacy of Krackow locking loop technique combined with the modified Kessler suture technique in the treatment of acute closed Achilles tendon rupture.Methods From January 2020 to January 2022,162 cases of acute closed Achilles tendon rupture were treated with Krackow locking loop technique combined with the modified Kessler suture technique.The patients were treated with the same postoperative rehabilitation plans.The American Orthopaedic Foot and Ankle Society(AOFAS)hindfoot score and Achilles Tendon Total Rupture Score(ATRS)were collected to evaluate the functions.Results The operation time was 24-40 min(mean,31.9±4.6 min).All incisions healed in one stage without infection or sural nerve injury.Complications occurred in 2 patients,including 1 case of deep venous thrombosis and 1 case of trauma-related re-rupture.The recovery time of ankle flexion and extension motion was4-12 weeks(mean,7.6±1.9 weeks),the recovery time of single-legged heel rise height on the affected side was 10-18 weeks(mean,13.3±1.8 weeks),and the recovery time of fast walking or jogging was 14-26 weeks(mean,19.1±1.8 weeks).The 162 patients was followed up for 14-25 months(mean,19.0 months).The AOFAS hindfoot score increased from(54.4±4.4)points preoperatively to(98.0±4.0)points at the last follow-up(t =-104.402,P =0.000).The ATRS score increased from(52.0±8.3)points preoperatively to(91.2±2.4)points at the last follow-up(t =-62.823,P = 0.000).Conclusions For young and middle-aged patients with acute closed Achilles tendon rupture,Krackow locking loop technique combined with the modified Kessler suture technique can achieve good clinical outcomes.Early functional exercise is required to return to work and life.