Objective:To explore the influence of operation timing on the prognosis of hip fracture in patients who used direct oral anticoagulant (DOAC) before injury.Methods:A retrospective case-control study was conducted to analyze the clinical data of 90 patients who used DOAC before hip fracture and were admitted to Nanjing Hospital of Chinese Medicine affiliated to Nanjing University of Chinese Medicine from January 2022 to August 2023. Among them, there were 53 males and 37 females, aged 65 to 89 years with a mean age of (76.24±6.92) years. Patients were divided into the early operation group ( n=45) and the delayed operation group ( n=45) according to the timing of operation. The early operation group underwent hip fracture surgery within 2 days after DOAC withdrawal, while the delayed operation group underwent hip fracture surgery more than 2 days after DOAC withdrawal. The two groups were compared and evaluated in terms of fracture site, surgical method, operation time, length of hospital stay, Harris hip score (HHS), intraoperative blood loss, blood transfusion rate, blood transfusion volume, hemoglobin (Hb) change rate, incidence of postoperative complications, intensive care unit (ICU) admission rate and duration, and mortality rate. The measurement data with normal distribution were expressed as mean ± standard deviation ( ± s), and intergroup comparison was performed using the t-test. The count data were expressed as cases and percentages, and intergroup comparison was conducted using the Chi-test or Fisher exact test probability method. Comparisons among multiple time points were analyzed by repeated measures analysis of variance. Results:There was no statistically significant differences were observed between the two groups in terms of fracture site and surgical method ( P>0.05). The ICU admission rate and length of hospital stay in the early operation group were lower than those in the delayed operation group, with statistically significant differences ( P<0.05). There were no statistically significant differences between the two groups in intraoperative blood loss, operation time, blood transfusion rate, blood transfusion volume, Hb change rate and other indicators ( P>0.05). The total incidence of postoperative complications in the early operation group was lower than that in the delayed operation group [15.6% (7/45) vs 53.3% (24/45)], with statistically significant difference ( P<0.05). The HHS score of the early operation group at 1 month after operation was significantly higher than that of the delayed operation group, with statistically significant difference ( F=7.75, P<0.05). At 1 and 12 months after operation, there were no statistically significant differences in the mortality between the two groups of patients who used DOAC before hip fracture [0 (0/45) vs 2.2% (1/45); 4.4% (2/45) vs 6.7% (3/45); P>0.05]. Conclusion:For patients who used DOAC before injury, hip fracture surgery within 2 days after DOAC was stopped after admission can help to reduce the ICU admission rate, shorten the length of stay, reduce the risk of postoperative complications, and promote the early recovery of hip joint function, without affecting the amount of blood loss, blood transfusion rate and blood transfusion.

Objective To introduce a new way to solve the problem of field-field junction in the traditional radiotherapy of the nasopharyngeal carcinoma better.Methods Using the 3-dimentional planning system,the dose distribution of traditional radiotherapy and the electronic beam irradiation technology of L shape field for nasopharyngeal carcinoma in 2D-or 3D-CRT could be gotten.Results The dose coverage of V95 of the gross tumor volume(GTV)satisfied the clinical requirements.The highest dose in the electronic beam irradiation of L shape field was 7200 cGy,while it was 8900 cGy in the traditional way.The volume of dose that over 6500 cGy of throat was 19.64 ％ in the former,the latter was 31.95 ％.Conclusion The electronic beam irradiation technology of L shape field is better than the traditional radiotherapy in field-field junction and in dose distribution.Since that,the electronic beam irradiation technology of L shape field is worth of application for the treatment of nasopharyngeal carcinoma.

Objective To investigate the cognitive status of nursing of cancer patients among nurses of cardiothoracic surgery department,to discuss countermeasures to improve nursing quality of tumor patients of cardiothoracic surgery department. Methods 150 nurses of cardiothoracic surgery department from November 2009 to November 2010 in five hospitals of a certain city were selected as the research object.The elf-made questionnaire about cognition of cancer patients nursing was adopted for investigation.The cognition condition of health education,psychological care,death education,care of cancer pain of 150 nurses was taken for statistics. Results The study showed that 150 cardiothoracic surgical nurses mastered the health education knowledge best,the average score was(88.6 ± 11.3).The knowledge of death related knowledge was the worst,the average score was (64.5 ± 21.6).The differences of mastering degree of psychological care and pain related knowledge level for 5 hospital nurses were quite significant.The differences of psychological care knowledge levels of hospital A and C,D were significant.The differences of care of cancer pain of hospital B and A,E,F were significant. Conclusions Based on the cognitive status of cardiothoracic surgery nurses for nursing of cancer patients,appropriate theoretical and practical training can be adopted in order to improve cognitive level of related knowledge about nursing of cancer patients among cardiothoracic surgery nurses,so that the nursing quality for cancer patients can be improved.