Objective:To observe the clinical effect of tracheal tube with an attached laryngeal pillow cushion(LPC)in the patients under general anesthesia,and to provide new methods for the preventing arytenoid dislocation during tracheal intubation.Methods:Forty-eight patients scheduled for elective oral tracheal intubation under general anesthesia and meeting the inclusion criteria were selected.Based on the head and neck positions,the patients were divided into supine without pillow(SWOP)group,supine with pillow(SWP)group,trendelenburg position(TP)group,and head side position(HSP)group,each group consisted of 12 patients.The patient in the following groups underwent two sequential treatments after tracheal intubation:intervention group(LPC-inflated)and control group(LPC uninflated,representing the current method of tracheal tube use).One patient in TP group and two patients in HSP group rminated the experiment,so a total of 45 patients were successfully included in this study.Electronic fiber laryngoscopy was used to observe and record the positional relationship between the endotracheal tube LPC and the posterior commissure arytenoid joint area under different head and neck positions after two treatments.The evaluation indicators were whether the tracheal tube was lifted from the posterior commissure arytenoid joint area and the degree of compression of the tracheal tube on the arytenoid joint.The incidence of tracheal tube lift-off and the percentage of compression degree on cricoarytenoid joint of the patients in various groups were calculated.Results:Within the same head and neck position group,compared with control group,the incidence of endotracheal tube lift-off of the patients in intervention group was significantly increased(P<0.05),and the percentage of compression degree of endotracheal tube on the arytenoid joint was significantly decreased(P<0.05).In control and intervention groups,there were no statistically significant differences in the incidence of endotracheal tube lift-off and the percentage of compression degree on arytenoid joint of the patients in various head and neck positions groups(P>0.05).Conclusion:Under the four head and neck positions,inflating the LPC of the tracheal tube can lift the tracheal tube from the posterior commissure arytenoid joint area,effectively relieving or reducing the compression and mechanical friction injuries to the arytenoid joint.

Objective:To investigate the effect of internet nursing model on female patients who are undergoing in vitro fertilization-embryo transfer, improve the quality of nursing service in reproductive center.Methods:A total of 201 female patients undergoing in vitro fertilization-embryo transfer from April 2018 to December 2018 were divided into the intervention group(102 cases) and the control group(99 cases) by random digits table method. The patients in intervention group were treated with nursing care based on the internet platform, and the control group was given routine care. The duration of intervention was from the patients determined treatment plan to the time pregnancy test 14 days after embryo transfer. The Self-rating Anxiety Scale(SAS) and Self-rating Depression Scale(SDS), Fertility Quality of Life(FertiQoL), and Connor-Davidson Resilience Scale(CD-RISC) were used to evaluate the differences in anxiety and depression, quality of life, and psychological resilience before and after intervention. The outcome of in vitro fertilization-embryo transfer was observed in two groups.Results:After intervention, the score of SAS, SDS were 26.03±6.43, 28.79±5.26 in the intervention group, and 40.76±6.81, 36.13±6.27 in the control group, the difference were significant( t values were -15.77, -9.00, all P<0.01). After intervention,the dimensional scores of mental and physical, social relationship, tolerance to treatment in the FertiQoL were 68.21±18.34, 75.56±19.58, 69.14±18.91 in the intervention group, and 58.11±17.42, 67.24±19.27, 58.77±19.86 in the control group, the difference were significant( t values were 4.00, 3.04, 3.79, all P<0.01). After intervention,the dimensional scores of tough, optimistic in CD-RISC were 37.03±10.51, 14.02±3.25 in the intervention group, and 26.73±9.81, 10.13±3.41 in the control group, the difference were significant( t values were 7.17, 8.28, all P<0.01). The average number of high-quality embryos and clinical pregnancy rate were 1.79(0.59, 4.51), 49.02%(50/102) in the intervention group, and 1.22(0.36, 2.86) , 33.33% (33/99) in the control group, the difference were significant ( t value was 2.47, χ2 value was 5.10, all P<0.05). Conclusions:The new nursing model based on internet has positive significance for the treatment of female patients undergoing in vitro fertilization-embryo transfer, which can improve patients' anxiety and depression, improve their quality of life and enhance their psychological resilience.

OBJECTIVE:To investigate the therapeutic efficacy of edaravone combined with citicoline sodium on acute cere-bral infarction and its effects on the levels of oxidative stress and inflammatory factors. METHODS:108 patients with acute cere-bral infarction were randomly divided into edaravone group(single group)and edaravone+citicoline sodium group(drug combina-tion group),with 54 cases in each group. Based on routine treatment,single group was given Edaravone injection 30 mg added in-to 100 ml 0.9% Sodium chloride injection intravenously,bid,used up within 30 min each time;drug combination group was addi-tionally given Citicoline sodium injection 0.5 g added into 250 ml 0.9% Sodium chloride injection intravenously,qd,on the basis of single group. Treatment course of 2 groups lasted for 2 weeks. NIHSS,HDS,Barthel index,oxidant stress indicator and inflam-matory factors were compared between 2 groups before and after treatment. RESULTS:After treatment,the effective rate of NI-HSS in drug combination group was 81.48%,which was significantly higher than single group(53.70%),with statistical signifi-cance (χ2=9.511,P=0.002). HDS score and Barthel index of 2 groups were significantly increased after treatment,especially in drug combination group,with statistical significance(P<0.05). Compared with before treatment,contents of MDA and ET-1 in 2 groups were decreased significantly,while SOD activity and NO content were increased significantly;the inflammatory cytokines IL-6,IL-8,IL-12 and IL-16,TNF-α were all decreased gradually,with statistical significance (P<0.05);the improvement of each indicator in drug combination group was more significant than single group,with statistical significance(P<0.05). CONCLU-SIONS:Edaravone combined with citicoline sodium show good therapeutic efficacy in the treatment of acute cerebral infarction, can decrease the levels of oxidative stress and inflammation and promote the recovery of the neurological function and the daily liv-ing ability.