Objective:To explore the effect of applying the multi-disciplinary team（MDT）model led by specialized nursing care in the treatment carried out at early stage in intensive care unit of hyperbaric oxygen（ICU-HBO）for patients with brain complications after Stanford type A aortic dissection（AD）surgery.Method:From January 2018 to December 2020，a total of 18 patients with brain complications after AD surgery were included and treated by ICU-HBO with MDT model. The patients’ ventilator tolerance and weaning time，outcome，occurrence of adverse events，and satisfaction rate of nursing care were observed.Results:（1）Fifteen mechanically ventilated patients were successfully weaned off the machine after 1-5 times of ICU-HBO treatment.（2）Sixteen patients regained their consciousness to the normal level after 2-13 times of ICU-HBO treatments，with the total effective rate of 88.89%；two patients in persistent vegetative state（deep coma）discontinued the treatment after two times of ICU-HBO treatments as their family gave up. During the follow-up period of six months to two years，11 cases were found clinically cured，one case was considered effective，four cases lost contact，and the two cases that had gave up treatment died of complications.（3）No adverse medical event（related to safety）occurred during the ICU-HBO treatment.（4）The satisfaction rate of nursing care was 100%.Conclusion:In the early ICU-HBO treatment of patients with brain complications after Stanford type A AD surgery，the application of MDT mode led by specialized nursing care is beneficial to the treatment risk control，ensure the treatment effectiveness，and improve the long-term prognosis，and quality of life of AD patients.

Objective:To explore the effect of applying the multi-disciplinary team（MDT）model led by specialized nursing care in the treatment carried out at early stage in intensive care unit of hyperbaric oxygen（ICU-HBO）for patients with brain complications after Stanford type A aortic dissection（AD）surgery.Method:From January 2018 to December 2020，a total of 18 patients with brain complications after AD surgery were included and treated by ICU-HBO with MDT model. The patients’ ventilator tolerance and weaning time，outcome，occurrence of adverse events，and satisfaction rate of nursing care were observed.Results:（1）Fifteen mechanically ventilated patients were successfully weaned off the machine after 1-5 times of ICU-HBO treatment.（2）Sixteen patients regained their consciousness to the normal level after 2-13 times of ICU-HBO treatments，with the total effective rate of 88.89%；two patients in persistent vegetative state（deep coma）discontinued the treatment after two times of ICU-HBO treatments as their family gave up. During the follow-up period of six months to two years，11 cases were found clinically cured，one case was considered effective，four cases lost contact，and the two cases that had gave up treatment died of complications.（3）No adverse medical event（related to safety）occurred during the ICU-HBO treatment.（4）The satisfaction rate of nursing care was 100%.Conclusion:In the early ICU-HBO treatment of patients with brain complications after Stanford type A AD surgery，the application of MDT mode led by specialized nursing care is beneficial to the treatment risk control，ensure the treatment effectiveness，and improve the long-term prognosis，and quality of life of AD patients.

Objective:To analysis the construction of the world's top PhaseⅠclinical trial registration agencies, compare their size, composition, operation and funding, to provide further reference for the construction of clinical trial agency in China.Methods:Search for PhaseⅠclinical trial research agencies by region on clinicaltrials.gov. Collecting information about the agency’s management, staffing, implementation in Asia, America and Europe. Descriptive analysis was carried out to explore the type, proportion and operation among different regions, the organizational structure, operational management and effectiveness of each agency from different regions were compared.Results:The United States, Europe and East Asia are dense areas of PhaseⅠclinical research around the world. The types of agencies in the United States, Britain, France, Germany, South Korea, Japan, and Israel are mainly enterprises. Among other types of agencies, the organizational models are diversified. The agencies have different spatial distances from medical institutions, but possess relatively consistent scale and institutional operation. All the agencies have a stable source of funding.Conclusions:In order to strengthen the construction of clinical trial agencies in China, we should speed up the establishment of a close connection mechanism to promote deep cooperation in clinical trials. Control the construction scale and maintain stable input of the agency. Meanwhile, establish and strengthen international exchanges and cooperation.

Objective To observe the oxygen-breathing efficacy by using different breathing apparatuses during normal pressure oxygen-breathing treatment and HBO treatment (HBOT) in the multi-seats chamber.Methods Changes in curve of transcutaneous oxygen partial pressure (TcPO2) for the 30 subjects,who had oxygen-breathing both at normal pressure and at a pressure of 0.22 MPa by using different types of apparatus were monitored continuously.Results (1) The curves of normal TcPO2 both at normal pressure and at 0.22 MPa were displayed in three stages:the compressing stage (1-5min after oxygen-breathing started until peak was reached) ; the plateau peak stage (the time when the peak arrived till decompression started) ; the decompression stage (the time when decompression was started till 20 minutes after oxygen-breathing was terminated).The elevation and declining of the curve synchronized with oxygen-breathing.(2) Oxygenbreathing by using different types of breathing apparatus tended to induce changes in the TcPO2 curves.(3)Before entrance into the chamber,instruction on the correct wearing of oxygen-breathing apparatus was an important measure for maintenance of the TcPO2 curves.Conclusions The TcPO2 curves synchronized with oxygen-breathing and was obviously affected by different types of apparatus.The TcPO2 curve could be used as an objective indicator for dynamic and real-time monitoring of oxygen-breathing efficacy in the multi-seats chamber.

Objective To observe the oxygen-breathing efficacy by using different breathing apparatuses during normal pressure oxygen-breathing treatment and HBO treatment (HBOT) in the multi-seats chamber.Methods Changes in curve of transcutaneous oxygen partial pressure (TcPO2) for the 30 subjects,who had oxygen-breathing both at normal pressure and at a pressure of 0.22 MPa by using different types of apparatus were monitored continuously.Results (1) The curves of normal TcPO2 both at normal pressure and at 0.22 MPa were displayed in three stages:the compressing stage (1-5min after oxygen-breathing started until peak was reached) ; the plateau peak stage (the time when the peak arrived till decompression started) ; the decompression stage (the time when decompression was started till 20 minutes after oxygen-breathing was terminated).The elevation and declining of the curve synchronized with oxygen-breathing.(2) Oxygenbreathing by using different types of breathing apparatus tended to induce changes in the TcPO2 curves.(3)Before entrance into the chamber,instruction on the correct wearing of oxygen-breathing apparatus was an important measure for maintenance of the TcPO2 curves.Conclusions The TcPO2 curves synchronized with oxygen-breathing and was obviously affected by different types of apparatus.The TcPO2 curve could be used as an objective indicator for dynamic and real-time monitoring of oxygen-breathing efficacy in the multi-seats chamber.

Objective To observe characters of sputum of patients with tracheotomy by heat and moisture exchanger(HEM)undergoing hyperbaric oxygen therapy(HBOT)in multi-person chamber.Methods In randomly block design,239 patients were selected and received HBOT using HEM combined with L-shape tube(group HEM,n=128)and by L-shape tube(group L,n=111)respectively.The characters and volume of sputum,times of sucking sputum and cases of sealing/extubation of tubes were assessed over first and tenth sessions of HBOT.Results The times of sucking and volume of sputum over first session of HBOT in the group HEM were more than those in group L.The sputum was changing from ropiness over first session to tenuity over tenth sesion(P＜0.01).Cases with sealing/extubation of tubes in group HEM were more than those of group L(P＜0.01).Conclusions It is helpful to humidify and discharge deposited sputum of patients over routine hyperbaric oxygen by HEM.And the case8 of sealing/extubation of tubes are also reduced.