Objective:To develop a double-set endotracheal intubation and evaluate its effectiveness.Methods:The development of a double-set endotracheal intubation was achieved by integrating endotracheal intubation with dental pads. From November 2023 to July 2024, convenience sampling was used to select 60 patients with endotracheal intubation admitted to the ICU of the First Hospital of Jiaxing as participants. Patients were divided into an experimental group ( n=30) and a control group ( n=30) using a random number table method. Experimental group was treated with a double-set endotracheal intubation, while control group was treated with a regular endotracheal intubation. The incidence of oral mucosal membrane pressure injury and oral ulcers during endotracheal intubation, the Chinese version of the modified Beck Oral Assessment score, plaque index, and endotracheal intubation duration were compared between two groups of ICU patients. Results:The duration of endotracheal intubation in experimental group was shorter than that in control group ( P<0.05), and the difference was statistically significant ( P<0.05). The number of cases with oral mucosal membrane pressure injury and oral ulcers in experimental group, as well as the Chinese version of the modified Beck Oral Assessment score, were lower than those in control group, and the differences were statistically significant ( P<0.05). There was no statistically significant difference in the plaque index between two groups ( P>0.05) . Conclusions:Double-set endotracheal intubation can effectively improve the efficiency of intubation in ICU patients, reduce the local pressure on oral tissues caused by intubation, improve the oral condition of patients, and have good clinical effects.

Objective:To develop a double-set endotracheal intubation and evaluate its effectiveness.Methods:The development of a double-set endotracheal intubation was achieved by integrating endotracheal intubation with dental pads. From November 2023 to July 2024, convenience sampling was used to select 60 patients with endotracheal intubation admitted to the ICU of the First Hospital of Jiaxing as participants. Patients were divided into an experimental group ( n=30) and a control group ( n=30) using a random number table method. Experimental group was treated with a double-set endotracheal intubation, while control group was treated with a regular endotracheal intubation. The incidence of oral mucosal membrane pressure injury and oral ulcers during endotracheal intubation, the Chinese version of the modified Beck Oral Assessment score, plaque index, and endotracheal intubation duration were compared between two groups of ICU patients. Results:The duration of endotracheal intubation in experimental group was shorter than that in control group ( P<0.05), and the difference was statistically significant ( P<0.05). The number of cases with oral mucosal membrane pressure injury and oral ulcers in experimental group, as well as the Chinese version of the modified Beck Oral Assessment score, were lower than those in control group, and the differences were statistically significant ( P<0.05). There was no statistically significant difference in the plaque index between two groups ( P>0.05) . Conclusions:Double-set endotracheal intubation can effectively improve the efficiency of intubation in ICU patients, reduce the local pressure on oral tissues caused by intubation, improve the oral condition of patients, and have good clinical effects.

Objective: To investigate the relationship between 18F-FDG PET/CT semi-quantitative parameters and the International Association for the Study of Lung Cancer, American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS) histopathologic classification, including histological subtypes, proliferation activity, and somatic mutations. Materials and Methods: This retrospective study included 419 patients (150 males, 269 females; median age, 59.0 years;age range, 23.0–84.0 years) who had undergone surgical removal of stage IA–IIIA lung adenocarcinoma and had preoperative PET/CT data of lung tumors. The maximum standardized uptake values (SUVmax), background-subtracted volume (BSV), and background-subtracted lesion activity (BSL) derived from PET/CT were measured. The IASLC/ATS/ERS subtypes, Ki67 score, and epidermal growth factor/anaplastic lymphoma kinase (EGFR/ALK) mutation status were evaluated. The PET/CT semiquantitative parameters were compared between the tumor subtypes using the Mann–Whitney U test or the Kruskal–Wallis test. The optimum cutoff values of the PET/CT semi-quantitative parameters for distinguishing the IASLC/ATS/ERS subtypes were calculated using receiver operating characteristic curve analysis. The correlation between the PET/CT semi-quantitative parameters and pathological parameters was analyzed using Spearman’s correlation. Statistical significance was set at p < 0.05. Results: SUVmax, BSV, and BSL values were significantly higher in invasive adenocarcinoma (IA) than in minimally IA (MIA), and the values were higher in MIA than in adenocarcinoma in situ (AIS) (all p < 0.05). Remarkably, an SUVmax of 0.90 and a BSL of 3.62 were shown to be the optimal cutoff values for differentiating MIA from AIS, manifesting as pure ground-glass nodules with 100% sensitivity and specificity. Metabolic-volumetric parameters (BSV and BSL) were better potential independent factors than metabolic parameters (SUVmax) in differentiating growth patterns. SUVmax and BSL, rather than BSV, were strongly or moderately correlated with Ki67 in most subtypes, except for the micropapillary and solid predominant groups. PET/CT parameters were not correlated with EGFR/ALK mutation status. Conclusion As noninvasive surrogates, preoperative PET/CT semi-quantitative parameters could imply IASLC/ATS/ERS subtypes and Ki67 index and thus may contribute to improved management of precise surgery and postoperative adjuvant therapy.

Objective To design the bedside tracheotomy checklist to improve the safety of operation.Methods According to the quality requirements of bedside tracheotomy and perioperative coordination, all the preparatory work and cooperation work in the duration had been summarized and enlist in the ICU bedside tracheotomy checklist. Patients who underwent bedside tracheotomy were enrolled in this study. Sixty-eight patients were evenly and randomly divided into observation group (using ICU bedside tracheotomy checklist) and control group (without the checklist), and each group with 34 cases. Observation and comparison of the two groups were conducted in the passing rate, the operation time and the satisfaction of nursing cooperation. Results The operation time in observation group was (10.94±1.92)min for bedside tracheotomy, while it was (15.00±3.95)min in the control group, and there was statistical significance between two groups (t =-5.383, P<0.01). The qualified rates for operation cooperation were 88.24% in observation group and 35.29% in the control group (χ2=20.176,P<0.01). The doctor's satisfaction was (3.88±0.33) score while nurse's was (3.94±0.24) in observation group, which all were higher than that of control group (t=4.672,5.652;P <0.05). Conclusions The use of ICU bedside tracheotomy checklist after bedside tracheotomy operation tends to make the process standardized, and to ensure the safety of patients, increasing the satisfaction of medical cooperation. It proves its feasibility in clinical practice.

Objective To explore the factors related to the amount of suction under glottis, look for effective nursing counter measures in order to improve the suction effects. Methods A retrospective analysis of the clinical data of 71 patients with subglottic secretion drainage from 1st January 2013 to 1st May 2014 was performed. The secretion viscosity, posture, the endotracheal tube cuff pressure, patients restlessness, suction pressure, and acute physiology and chronic health evaluationⅡscore were set as independent variables. A multiple linear regression analysis was performed to screen factors that may lead to reduction of suction volume of subglottic secretion and nursing counter measures were planned and implemented accordingly. Results Secretion viscosity, supine, endotracheal tube cuff pressure and patient restlessness were the main reasons that influence the amount of suction under glottis(P<0. 05). Multiple linear regression equation:amount of suction of subglottic secretion/2 h(ml) =4. 868 +2. 470 × restlessness-1. 624 × secretion viscosity+0. 874 × endotracheal tube cuff pressure-0. 933 × posture. Conclusions Quantity of suction of subglottic secretion were positively correlated to patients′restlessness, secretion viscosity and endotracheal tube cuff pressure. Subglottic attract amount for the most when take left lateral position. Strengthening the control and intervention of related factors plays a very important role in the care of suction under glottis.

Objective To prevent unplanned extubation,reduce complications caused by restraint, improve satisfaction degree of patients′relatives,and to lower nurses′work stress.Methods Transparent restraint protection gloves were developed,within which fingers could move freely and with the help of which unplanned extubation could be prevented.A total of 1 00 ICU patients were selected and divided into intervention group and control group randomly,each with 50 cases.Patients in the intervention group used the new type restraint gloves,while patients in the control group used traditional ones.Restraint effects of the two groups were compared.Results Unplanned extubation happened to non patient in the intervention group,while it happened to 6 cases in the control group,Fisher′s exact test was used in comparison between the two groups (P <0.05). Scores of satisfaction degree in the intervention group were (3.1 4 ±0.639)points,while the scores in the control group were (2.20 ±0.756)points (t =6.71 4,P <0.01 );scores of nurses′work stress on accident extubation of patients in the intervention group were (2.1 2 ±0.761 )points,lower than that in the control group with (t =-8.696,P <0.01 ).Conclusions Transparent restraint protection gloves can effectively prevent unplanned extubation,reduce complications caused by restraint,improve satisfaction degree of patients′relatives,and lower nurses′work stress.

Objective To study the psychosocial behavior reaction,psychosocial needs,anxiety and depression among colostomy patients prior to discharge and to explore the relationship between them.Methods Totally 67 colostomy patients from 2 hospitals in Guangzhou were recruited and investigated by demographic questionnaire,Ostomy Psychosocial Behavior Reaction Questionnaire,Ostomy Psychosocial Needs Questionnaire,Hospital Anxiety and Depression Scale 1-2 days prior to discharge.Results The psychosocial behavior reaction among coIostomy patients was in the moderate level with the mean score 2.15±0.27.The psychosocial needs were in medium to high level with the mean score 2.09±0.41.About 37.3％ of colostomy patients showed anxiety,while 20.9％ patients showed depression.Significant positive correlation was shown between psychosocial behavior reaction and psychosocial needs(r=0.565,P＜0.01),while significant positive correlation was also shown between psychosocial behavior reaction and anxiety-depression(r=-0.472,-0.319,P＜0.01).Psychosocial needs and anxiety could predict psychosocial behavior reaction positively(β=0.486,-0.375,P＜0.01).Conclusion The positive acknowledgement and reconstruction are the main psychosocial behavior reactions prior to discharge in colostomy patients.Patients with more psychosocial needs,severe anxiety show more psychosocial behavior reaction.

Objective To observe the effect of the continuous low pressure suctioning unite intermittent high pressure suctioning on drainage of subglottic secretions in the patients with artificial airway.Methods Using random number table,a total of 44 patients were evenly and randomly divided into observation group and control group.In the control group,continuous low pressure suctioning was performed to clear away the subglottic secretions.In the observation group,continuous low pressure suctioning combined with intermittent high pressure suctioning were performed.The average daily drainage volume of subglottic secretion,the incidence of early onset VAP (Ventilatorassociated pneumonia),the frequence of cough,the incidence of the airway mucosal damage,the incidence of the clogging of the drainage tube were investigated and compared between two groups.Results The average daily drainage volume of subglottic secretion in the observation group (52.80 ±4.181)ml was significantly more than in the control group (33.00 ± 2.675) ml (t =16.656,P ＜ 0.05).The incidence of early onset VAP in the observation group (10.0％) was significantly less than in the control group (40.0％) (x2 =4.800,P ＜ 0.05).There was no statistical difference in the frequence of cough between the observation group (1.93 ± 1.023) times and the control group (1.75 ± 1.006) times (t =0.771,P ＞ 0.05).There was no statistical difference in the incidence of the mucosal damage of airway between the observation group (15％) and the control group(10％) (x2 =0.229,P ＞0.05).The incidence of the clogging of the drainage tube in the observation group (0.0％) was significantly less than in the control group (20.0％) (x2 =4.444,P ＜0.05).Conclusions Continuous low pressure suctioning combined with intermittent high pressure suctioning can significantly improve the effect of drainage of the subglottic secretions by increasing the drainage volume,reducing the clogging of the drainage tube and the early onset of VAP.

OBJECTIVE: To Study the personality characteristics in patients with sudden deafness. METHOD: Thirty-eight sudden deafness patients and 45 healthy volunteers were assessed by Eysenck personality questionnaire (EPQ). RESULT: The standard scores of P, E, N dimensions of patients with sudden deafness were greater than healthy volunteers. The standard score in L dimensions of patients with sudden deafness was less than healthy volunteers. The difference of the standard score of P dimension revealed statistical significance (P < 0.05). The difference of the standard score of N dimension revealed statistical significance (P < 0.01). The difference of the standard scores of E, L dimensions revealed no statistical significance (P > 0.05). CONCLUSION Sudden deafness patients have emotional instability and psychoticism personality characteristics.
Adolescent ; Adult ; Case-Control Studies ; Female ; Hearing Loss, Sudden ; psychology ; Humans ; Male ; Middle Aged ; Personality ; Young Adult

A male patient, 55 years old, suffered from intermittent sound,voice depression and shortness of breath for one year,and from dysphagia for 3-4 months. Through fiber laryngoscopy,we could see tumor in the left posterior aryepiglottic fold. The tumor's surface was smooth. A portion of the tumor protruded to the laryngeal cavity and the aryepiglottic fold external,it also covered most of the glottis. Bilateral vocal cord were smooth and had good mobility. Throat CT demonstrated an irregular soft tissue mass on the left side of the aryepiglottic fold in supraglottic area with obscure normal boundary from adjacent structure. The left side of pyriform sinus became shallow without obvious bone destruction. The pathological report showed pleomorphic adenoma. The diagnosis was laryngeal pleomorphic adenoma.
Adenoma, Pleomorphic ; Humans ; Laryngeal Neoplasms ; Male ; Middle Aged