Objective To investigate the impacts of percutaneous endoscopic interlaminar discectomy(PEID)on pain level and lumbar function in patients with lumbar disc herniation(LDH).Methods From January 2022 to August 2023,84 patients were diagnosed with L4/5 LDH based on clinical data and imaging information were selected as the study subjects.And they were assigned into 42 cases in experimental group and 42 cases in traditional groups complying with treatment methods.The traditional group underwent traditional open approach treatment,while the experimental group underwent PEID.The surgical indicators(including hospitalization time,surgical time,bed rest time,and intraoperative fluoroscopy frequency),the levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were compared between the two groups,the visual analogue scale(VAS)score and Oswestry disability index(ODI)were used to quantify the pain level of waist and lower limbs and lumbar function,and the excellent and good rate of clinical satisfaction and the incidence of complications were compared.Results The hospitalization time and bed rest time of the experimental group were obviously shorter than those of the traditional group,while the fluoroscopy frequency was less than that of the traditional group,and surgical time was longer than that of the traditional group,the differences were statistically significant(P＜0.05).After treatment,the pain VAS score and ODI of waist and lower limbs,the IL-6,and TNF-α in the two groups were lower than those before treatment,the experimental group was lower than the traditional group,the differences were statistically significant(P＜0.05).The excellent and good rate of the experimental group and the traditional group were 88.10％and 83.33％,respectively,with no statistically significant difference(P＞0.05).There was no statistically significant difference in the total incidence of complications between the two groups(P＞0.05).Conclusion PEID surgery can effectively alleviate nerve compression,alleviate pain of waist and lower limbs,promote the recovering of lumbar function,and facilitate postoperative recovery in LDH patients.

Objective To investigate the impacts of percutaneous endoscopic interlaminar discectomy(PEID)on pain level and lumbar function in patients with lumbar disc herniation(LDH).Methods From January 2022 to August 2023,84 patients were diagnosed with L4/5 LDH based on clinical data and imaging information were selected as the study subjects.And they were assigned into 42 cases in experimental group and 42 cases in traditional groups complying with treatment methods.The traditional group underwent traditional open approach treatment,while the experimental group underwent PEID.The surgical indicators(including hospitalization time,surgical time,bed rest time,and intraoperative fluoroscopy frequency),the levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were compared between the two groups,the visual analogue scale(VAS)score and Oswestry disability index(ODI)were used to quantify the pain level of waist and lower limbs and lumbar function,and the excellent and good rate of clinical satisfaction and the incidence of complications were compared.Results The hospitalization time and bed rest time of the experimental group were obviously shorter than those of the traditional group,while the fluoroscopy frequency was less than that of the traditional group,and surgical time was longer than that of the traditional group,the differences were statistically significant(P＜0.05).After treatment,the pain VAS score and ODI of waist and lower limbs,the IL-6,and TNF-α in the two groups were lower than those before treatment,the experimental group was lower than the traditional group,the differences were statistically significant(P＜0.05).The excellent and good rate of the experimental group and the traditional group were 88.10％and 83.33％,respectively,with no statistically significant difference(P＞0.05).There was no statistically significant difference in the total incidence of complications between the two groups(P＞0.05).Conclusion PEID surgery can effectively alleviate nerve compression,alleviate pain of waist and lower limbs,promote the recovering of lumbar function,and facilitate postoperative recovery in LDH patients.

Objective To develop a postoperative precision nursing program for children with obstructive sleep apnea-hypopnea syndrome(OSAHS),so as to provide references for the improvement of nursing quality for children with OSAHS.Methods Literature in precision nursing for children with OSAHS was systematically reviewed and summarised based on precision nursing theory and a postoperative precision nursing program was drafted.Using the Delphi's Method,two rounds of expert consultation were conducted and the postoperative precision nursing program for children with OSAHS was revised and finalised.Results The response rates of the two rounds of expert consultation were 100.00%with the expert authority coefficient of 0.875.The Kendall coefficient of concordance(W)of levels 1,2 and 3 indices in the second round of expert consultation were 0.289,0.203,0.187,respectively(all P<0.01).The importance score of each inclicator ranged from 4.50～4.94.The coefficient of variations for the three-level indices ranged from 0.05 to 0.21.The finalised program composed 8 level-1 indices(postoperative position assessment,intervention,prevention and care of bleeding,maintaining postoperative airway patency,postoperative nausea and vomiting care,postoperative pain assessment and care,dietary care,complication prevention and care,discharge guidance),16 level-2 indices,and 22 level-3 indices.Conclusion The postoperative precision nursing program for the children with OSAHS is scientific,innovative and applicable.It provides clinical references for nursing of the children with OSAHS.

Objective To develop a postoperative precision nursing program for children with obstructive sleep apnea-hypopnea syndrome(OSAHS),so as to provide references for the improvement of nursing quality for children with OSAHS.Methods Literature in precision nursing for children with OSAHS was systematically reviewed and summarised based on precision nursing theory and a postoperative precision nursing program was drafted.Using the Delphi's Method,two rounds of expert consultation were conducted and the postoperative precision nursing program for children with OSAHS was revised and finalised.Results The response rates of the two rounds of expert consultation were 100.00%with the expert authority coefficient of 0.875.The Kendall coefficient of concordance(W)of levels 1,2 and 3 indices in the second round of expert consultation were 0.289,0.203,0.187,respectively(all P<0.01).The importance score of each inclicator ranged from 4.50～4.94.The coefficient of variations for the three-level indices ranged from 0.05 to 0.21.The finalised program composed 8 level-1 indices(postoperative position assessment,intervention,prevention and care of bleeding,maintaining postoperative airway patency,postoperative nausea and vomiting care,postoperative pain assessment and care,dietary care,complication prevention and care,discharge guidance),16 level-2 indices,and 22 level-3 indices.Conclusion The postoperative precision nursing program for the children with OSAHS is scientific,innovative and applicable.It provides clinical references for nursing of the children with OSAHS.

AIM: To evaluate the effect of remimazolam on early postoperative cognitive function in elderly patients with hip fracture based on a randomized controlled trial. METHODS: A total of 106 elderly patients, aged 65-90 years, ASA grade Ⅱ or III, who underwent hip fracture surgery under combined spinal-epidural anesthesia in the Sixth Affiliated Hospital of Wenzhou Medical University from December 2022 to June 2023 and met the inclusion criteria, were selected and randomized into remimazolam group (group R) and propofol group (group P) according to the random number table, with 53 cases in each group. Patients in group P received a slow intravenous injection of propofol at a dose of 0.3-0.5 mg / kg (injection time of 1min), followed by a pump infusion at 0.5-3 mg · kg

【Objective】 To investigate the application of 5W+ 1H combined with ECRS analysis principle in reducing the under-reporting rate of adverse reactions to blood transfusion (ARBT). 【Methods】 The causes of under-reporting rate of ARBT were analyzed using 5W+ 1H combined with ECRS analysis principle in Department of Hematology, and the countermeasures and intervention measures were carried out. The under-reporting rate of ARBTs before(January 2018 to December 2019, control) and after(January 2016 to December 2017, test) the interventions was compared. 【Results】 After the application of 5W+ 1H combined ECRS analysis principle, the under-reporting rate of ARBTs decreased significantly(17.39% test vs 37.67% control) (P<0.05). 【Conclusion】 The application of 5W+ 1H combined ECRS analysis principle can effectively reduce the under-reporting rate of ARBT, improve the report management of it, and improve the safety of the blood products.

Objective:To study the cause of 1 PICC catheter rupture, and discuss the nursing interventions.Methods:Comprehensive analysis was carried out on the review of the use and maintenance of PICC catheter, patient's life style and catheter quality test.Results:The main reasons of PICC catheter rupture were the pinch-off syndrome and catheter plug caused by gaming disorders and non-canonical maintenance of PICC outhospital.Conclusions:With the growing of video game players, gaming disorder may be one acquired factor of PICC catheter rupture. To reduce the occurrence of PICC catheter rupture, prompt identification of and timely intervention to gaming disorder and intensified outhospital care are paramount. The predictive diagnostic tests of catheter ectopia based on clinical syndromes, physical signs and catheter state, are helpful for the early recognition and treatment of PICC catheter rupture, followed by the risk reduction of pulmonary embolism.

Objective? To explore the effects of abdominal rotation timing and positioning card on subcutaneous injection for patients with multiple myeloma (MM). Methods? Totally 90 MM patients hospitalized in the department of Hematology, the Second Xiangya Hospital of Central South University from July 2017 to July 2018 were selected and stratified into observation (n=45) and control (n=45) groups according to the random number table. Patients in both groups were injected with Bortezomib through the abdomen subcutaneously. Patients in the control group received conventional subcutaneous injection, while patients in subcutaneous injection using the abdominal rotation timing and positioning card. Visual Analogue Scale (VAS) scores, incidence rate of adverse effects at the injection site and time of single administration were compared between the two groups after 4 courses of treatment. Results? Totally 43 patients from the observation group and 42 patients from the control group completed the study. The VAS score was (3.69±0.93) in the observation group, lower than (4.99±1.27) in the control group, and there was statistically significant difference between the two groups post intervention (P＜0.05). The incidence rate of adverse effects at the injection site was 6.20% (45/724) in the observation group, lower than 12.80%(89/696) in the control group, and there was statistically significant difference between the two groups post intervention (P＜0.05). The time of single administration was (7.77±0.60) min in the observation group, shorter than (8.38±0.57) min in the control group, and there was statistically significant difference between the two groups post intervention (P＜0.05). Conclusions? Compared with conventional abdominal subcutaneous injection, the use of the abdominal rotation timing and positioning card in subcutaneous injection for MM patients may reduce the sense of pain and the incidence of adverse effects at the injection site as well as the time for nursing operation, and improve nurses' working efficiency, which is easy to make and worthy promoting in clinical nursing practice.

HOXD-AS1 is a recently discovered pivotal cancer-related long non-coding RNA(lncRNA) .Abnormal expression of HOXD-AS1 exhibits a regulatory role in the occurrence and development of tumors,and is expected to become a new tumor marker.Clarifying the mechanism of HOXD-AS1 will provide a feasible theoretical basis and potential intervention targets for the diagnosis and treatment of tumors.This article reviews the current research status of HOXD-AS1 in tumors.

Objective To investigate the characteristics of self perceived burden (SPB) in patients with chronic obstructive pulmonary disease (COPD) and explore the relationship between the perceived burden and self-efficacy,coping style.Methods A total of 96 cases with COPD in our hospital from January 2015 to June 2017 were enrolled in the study.The clinical data of patients were retrospectively analyzed.The patients were surveyed by self perceived burden scale,self-efficacy scale and coping style scale.The relationship between self perceived burden and self efficacy,coping style were investigated.Results The self perceived burden score of COPD patients was (33.76 ± 7.65) points with moderate level.The symptom management self-efficacy,common disease management self-efficacy score of COPD patients were (8.13 ± 1.09) and (8.22 ± 1.13) respectively with moderate self-efficacy.The total score of coping style in COPD patients was (35.09 ± 10.83) points with positive coping style.The each dimension and the total score of self perceived burden were negatively correlated with positive coping style in COPD patients (P ＜ 0.05),and positively correlated with negative coping styles (P ＜ 0.05).The total score of coping style had no significant correlation with perceived burden scores (P ＞ 0.05).The each dimension and the total score of self perceived burden were negatively correlated with the each dimension scores and total scores of self-efficacy in COPD patients (P ＜ 0.05).Conclusions There are significant correlation between SPB and self-efficacy and coping style in COPD patients.Medical staff should strengthen communication with patients,and guide them with positive coping style in the face of disease,which can effectively improve their self-efficacy and reduce the self perceived burden and promote physical and mental health.