Thoracic anesthesia with spontaneous respiration represents a form of precision anesthesia meticulously customized to individual patients.Considering the more stringent requirements this anesthesia approach imposes on the regulation of respiratory function,the writing group of the"Consensus of Experts on the Management of Thoracic Anesthesia with Spontaneous Respiration"has formulated elaborate guidelines regarding indications and contraindications,preoperative evaluation,anesthesia implementation,common complications,and treatment strategies.This was accomplished by referencing relevant domestic and international literature and integrating it with actual clinical requirements.The objective is to standardize the rational application of this anesthesia method.

Thoracic anesthesia with spontaneous respiration represents a form of precision anesthesia meticulously customized to individual patients.Considering the more stringent requirements this anesthesia approach imposes on the regulation of respiratory function,the writing group of the"Consensus of Experts on the Management of Thoracic Anesthesia with Spontaneous Respiration"has formulated elaborate guidelines regarding indications and contraindications,preoperative evaluation,anesthesia implementation,common complications,and treatment strategies.This was accomplished by referencing relevant domestic and international literature and integrating it with actual clinical requirements.The objective is to standardize the rational application of this anesthesia method.

Purpose: This study developed an in-service training program for patient safety and aimed to evaluate the impact of the program on nurses in the operating room (OR). Methods: A pretest–posttest self-controlled survey was conducted on OR nurses from May 6 to June 14, 2020. An in-service training program for patient safety was developed on the basis of the knowledge–attitude–practice (KAP) theory through various teaching methods. The levels of safety attitude, cognition, and attitudes toward the adverse event reporting of nurses were compared to evaluate the effect of the program. Nurses who attended the training were surveyed one week before the training (pretest) and two weeks after the training (posttest). Results: A total of 84 nurses participated in the study. After the training, the scores of safety attitude, cognition, and attitudes toward adverse event reporting of nurses showed a significant increase relative to the scores before the training (p < .001). The effects of safety training on the total score and the dimensions of safety attitude, cognition, and attitudes toward nurses’ adverse event reporting were above the moderate level. Conclusion The proposed patient safety training program based on KAP theory improves the safety attitude of OR nurses. Further studies are required to develop an interprofessional patient safety training program. In addition to strength training, hospital managers need to focus on the aspects of workflow, management system, department culture, and other means to promote safety culture.

[Objective]To evaluated the clinical results of the ulnar osteotomy and external fixation for the treatment of chronic anterior dislocation of head of the radius in children.[Method]From 2002 to 2004,thirteen cases of children with chronic anterior dislocation of the radial head were treated by ulnar osteotomy,external fixation and close or open reduction of elbow joint but without repair of the annular ligament. Their mean age was 5.5 years(2 to 11) and the mean interval between the injury and reconstruction was 19 months(2 months to 3 years).[Result]All radial heads remained reduced at a mean follow-up of 14 months(2 months to 3 years).Normal ranges of movement for flexion,extension,pronation and supination were improved or unchanged in 12 patients.One patient had further decreased in 10? for supination.There were one superficial pin-track infections but with no serious complication.[Conclusion]Angular ulnar osteotomy and external fixation of the ulna can lead to stable reduction of the radial head with minimal complications.Reconstruction of the annular ligament is not necessary if satisfactory re-orientation of the ulnar is achieved in all planes.

[Objective] To discuss the clinical manifestations,treatment,and therapeutic efficacy of lumbar disc herniation complicated by lumbar spinal stenosis in elderly patients.[Method]Thirty-six elderly patients with lumbar disc herniation complicated by lumbar spinal stenosis were treated with surgical treatment,including multi-segment fenestration,laminectomy,resection of nucleus pulposus,and internal fixation of pedicle screws.The therapeutic efficacy was retrospectively assessed.[Result]All patients were followed up with an average time of 3 years and 6 months.The good to excellence results was 83%.[Conclusion]In elderly patients with lumbar spinal stenosis,there are patients have special clinical manifestations.Different operations should be adopted for different patients.There are several important factors that affect the efficacy of operation,including operation modes,sufficient decompression,restotation of spinal instability,and postoperative exercises of lumbodorsal muscles.

Objective To study the treatment of severe dysfunction of knee joint after trauma and explore the operative indication and method for total knee replacement treating such kind of disease. Methods From June 1997 to June 2004, total knee replacement using total knee prosthesis system was carried out in 21 knees of 18 cases with severe dysfunction of knee joint at late stage after knee replacement treating knee trauma, of which 12 knees in 10 cases with severe traumatic arthritis underwent total knee surface replacement. Seven knees in six cases with traumatic arthritis combined with 20?-40?varus or valgus or 20?-90?fixity flexion deformity and two knees in two cases with completely bony ankylosis were treated with rotation hinged knee joint. All cases were followed up for mean 3.5 years, ranging from six months to seven years. The Hospital for Special Surgery (HSS) knee rating score system was used to evaluate the clinical results. Results Pain relief, function recovery, rectification of knee deformities, stability and muscle power were all poor before operation. But postoperative valuation of pain relief, function recovery, rectification of knee deformities, stability and muscle power showed excellent result in 12 cases, good in seven and fair in two, with excellence rate of 90% and rate of patient satisfaction of 100%. Conclusion The knee replacement is an effective method for treating severe dysfunction of knee joint at late stage after knee replacement treating knee trauma.