Objective:To investigate the clinical efficacy of transfer of a free segment of the proximal second toe interphalangeal joint composite tissue flap in reconstruction of defects of interphalangeal joint of fingers, and simultaneously reconstruct the donor site defect left with the second toe by a transfer of a pedicled bone flap of the fibular proximal great toe.Methods:From December 2020 to April 2023, a total of 9 patients with interphalangeal joint defects of fingers were treated in the Department of Hand Microsurgery of Shunde Heping Surgery Hospital. The patients were 7 males and 2 females, aged 18-55 years old, with an average age of 31 years old. Firstly, transfers of a free segment of the proximal second toe interphalangeal joint composite tissue flap were performed to reconstruct the defects of finger joints. Simultaneously in the surgery, transfers of the fibular pedicled bone flap of the proximal great toe were conducted to reconstruct the donor site defects left in the second toe. Patients were instructed with appropriate postoperative functional exercises. K-wires were removed at 8-12 weeks after surgery. Outpatient visits, telephone and WeChat follow-ups were conducted to evaluate the appearance and functional recovery of the reconstructed interphalangeal joints and donor feet. Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, Vancouver Scar Scale (VSS) and American Orthopedic Foot and Ankle Society (AOFAS) foot function scoring standards were employed in the evaluation.Results:Postoperative follow-up lasted for 6 to 30 months. All of the 9 interphalangeal joint composite tissue flaps in the fingers survived with complete and good appearance. Function of the reconstructed interphalangeal joints of the fingers recovered well. According to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, the average score achieved 12 points, with 6 patients of excellent, 2 of good and 1 of fair. After surgery, the appearance and function of the donor great toes and second toes all recovered well. The average score of the scars in donor second toe evaluated by VSS was 4 points. All the donor feet were kept with 5 toes, with full, intact and good in appearance. According to the AOFAS foot function scoring standard, the average score achieved 95 points, and were excellent.Conclusion:Application of transfer of free proximal segment of interphalangeal joint composite tissue flap of the second toe in reconstruction of the interphalangeal joint defect of a finger, and simultaneously reconstruct the defect left with the donor second toe with a fibular proximal great toe flap pedicled with bone tissue can achieve good clinical efficacy in reconstruction of the defects of interphalangeal joint of fingers, restore the function of the interphalangeal joint of fingers and the appearance and function of the donor foot.

Objective:To analyze the status quo and advanced trend of voice training research in the world, and provide new ideas for voice training research in China.Methods:The literature on voice training in Web of Science core collection database was searched from January 1, 2013 to July 31, 2023, and visual analysis was performed using CiteSpace 6.1.R6 software.Results:A total of 964 papers were retrieved, and the number of published papers showed an increasing trend. The country with the largest number of publications was the United States, with 387. The Journal with the most publications was Journal of Voice. The research focused on voice rehabilitation of patients with different voice disorders, voice training intervention methods, improvement of quality of life and improvement of training compliance. The application of voice training in geriatric diseases might be a future research trend. Conclusions:At present, the field of voice training is deepening in the direction of new research and application, and the public's demand for voice rehabilitation is increasing. It is suggested that multidisciplinary collaboration should be strengthened in the future to explore the clinical efficacy of voice training in more different populations and diseases.

Objective:To explore the influencing factors of instrument and equipment alarm fatigue risk of nurses in pediatric intensive care unit (ICU) , establish a prediction model and verify its prediction efficiency.Methods:A multi-stage sampling method was used to select 300 pediatric ICU nurses from 2 tertiary children's specialized hospitals in Henan Province from October 2020 to March 2021 as the research objects for model construction. A total of 300 questionnaires were distributed and 225 valid questionnaires were recovered. From April to May 2021, 110 pediatric ICU nurses in Henan Children's Hospital were selected for model validation, 110 questionnaires were distributed and 100 valid questionnaires were recovered. A self-made baseline rating scale was used to collect relevant baseline information. The medical equipment alarm management questionnaire and the equipment alarm fatigue related scale were used for investigation. The Logistic regression model was used to establish the prediction model, Hosmer-Lemeshow test was used to test the fitting effect of the model and the receiver operating characteristic curve was used to evaluate the prediction value.Results:The 225 pediatric ICU nurses scored (48.67±4.35) for medical equipment alarm management factors, (39.67±3.67) for obstacles to medical equipment alarm management and (22.32±2.83) for clinical alarm fatigue. The results of multivariate analysis showed that the factors of age less than 30 years old, working years less than 5 years, working with illness, nurses with professional titles below, shift work, no habit of setting medical equipment alarms, and medical equipment management factors were all pediatric ICU nurses' equipment alarm fatigue. The independent risk factor of ICU ( P<0.05) . In this study, a prediction model was finally constructed. The area under the receiver operating characteristic curve (AUC) of the model was 0.887, the sensitivity was 0.891 and the specificity was 0.843. The validation data results showed that AUC value of the model was 0.901, the sensitivity was 0.912 and the specificity was 0.857. Conclusions:Pediatric ICU nurses have different degrees of equipment alarm fatigue. This research model can reliably predict the alarm fatigue risk of their equipment and equipment, suggesting that high-risk factors should be paid attention to and timely intervention measures should be carried out to reduce the risk of related adverse events.

Objective:Based on the theory of planned behavior (TPB), the exercise intervention program for breast cancer patients undergoing chemotherapy was constructed, and its application effect was preliminarily explored.Methods:A total of 116 patients receiving chemotherapy in the department of breast surgery from June to December 2021 in Shanxi Provincial Cancer Hospital were selected by purpose sampling method. The subjects were randomly divided into control group and experimental group by flipping a coin. The control group was given routine nursing, and the experimental group was given routine nursing on the basis of exercise intervention based on the theory of planned behavior. After three cycles of chemotherapy, the effects of the intervention were evaluated by piper Revised Fatigue Scale (RPFS), Exercise Self-efficacy Scale and Quality of Life Core Scale (EORTC QLQ-C30).Results:In the intervention stage, there were 2 cases in the experimental group and 3 cases in the control group lost. After the intervention, the total score and all dimensions (behavioral, emotional, sensory and cognitive) of cancer-induced fatigue in the experimental group were (2.30 ± 0.58), (2.21 ± 0.85), (2.32 ± 0.70), (2.66 ± 0.71) and (2.03 ± 0.58), which were lower than those in the control group (2.84 ± 0.44), (2.79 ± 0.60), (3.04 ± 0.75), (3.04 ± 0.60) and (2.53 ± 0.56), the differences were significant ( t values were 3.05-5.23, all P<0.05). The total scores of exercise self-efficacy and the dimensions of physical, psychological and social environment were higher than those of the control group ( t values were -7.63 - -3.31, all P<0.05). The scores of overall quality of life, physical function and emotional function were higher than those of the control group ( t = -3.48, -3.14,-2.34, all P<0.05), while the scores of fatigue and insomnia symptoms were lower than those in the control group ( t = 5.13, 3.14, both P<0.05). Conclusion:The exercise program based on the theory of planned behavior can improve the exercise self-efficacy of breast cancer patients undergoing chemotherapy, reduce cancer-related fatigue and improve their quality of life.

Nonalcoholic fatty liver disease (NAFLD) is a typical chronic liver disease closely associated with gut dysbiosis, and dietary factor may be the most important driving factor affecting the composition and function of intestinal bacteria. Based on the concept of enterotype, this article summarizes the effect of diet on enterotype-related gut microbiota in NAFLD, including Firmicutes/Bacteroidetes ratio, Bacteroides, Prevotella, Ruminococcus, Proteobacteria, Actinobacteria, and other bacteria. It is pointed out that improving diet to regulate gut microbiota is one of the important strategies for the prevention and treatment of NAFLD and has a good prospect, which needs further mechanism and clinical research.

In order to solve the problems of insufficient stimulation channels and lack of stimulation effect feedback in the current electrical stimulation system, a functional array electrode electrical stimulation system with surface electromyography (sEMG) feedback was designed in this paper. Firstly, the effectiveness of the system was verified through
Electric Stimulation ; Electrodes ; Electromyography ; Feedback ; Female ; Humans ; Male ; Neurofeedback

Objective: To develop a scientific oncology missed nursing care self-rating scale suitable for hospital culture background in China, and to test its validity and reliability. Methods: The initial scale was formulated by literature review, qualitative interview and delphi expert consultation. A total of 388 clinical nurses from Shanxi Province were selected by convenience sampling. Item analysis was used to filtrate items. The validity was evaluated by using evaluation scale of construction and content validity, and the reliability was tested by using internal consistency, split-half reliability and retest reliability. Results: Oncology missed nursing care self-rating scale consisted of 33 items and 4 dimensions including nursing assessment, nursing plan, basic nursing and nursing intervention. Exploratory factor analysis (EFA) revealed that 4 factors accounted for 63.664% of the accumulated variances. The scale-level content validity index (S-CVI) was 0.904. The Cronbach α coefficient was 0.948, the spilt-half reliability coefficient was 0.786, and the retest reliability coefficient was 0.833. Conclusion Oncology missed nursing care self-rating scale has good validity and reliability, which can be used as a measuring tool for oncology missed nursing care.

Objective: To explore the method of replanting severed piercing finger micro tissue blocks. Methods: From February, 2001 to October, 2016, 16 cases of severed piercing finger micro tissue blocks were replanted with debridement. The trunk or branch of proper palmar digital artery was anastomosed. Vascular collocations were used such as venous arterialization when there was no anastomotic artery available. Regular postoperative followed-up was performed to observe the recovery of tissue survival, appearance, sensation of flap, and joint function. Results: One case had partial epidermal necrosis, and healed after change of dressing. The finger-disconnected micro tissue blocks of other 15 cases survived well. After 6 months to 2 years of follow-up, the replanted micro tissue blocks were ruddy in color and recovered from S₃ to S₄. The appearance of the 16 fingers was good, and the function of joints was restored. Conclusion The finger-disconnected micro tissue blocks should be actively replanted. With skilled microsurgical techniques, the anastomosis of the arterial or venous artery will ensure the success of replantation and survived, as well as to restore good function and appearance.

Objective To investigate the risk factors associated with epididymitis after transurethral resection of prostate.Methods A retrospective analysis of 352 patients with benign prostatic hyperplasia (BPH) who underwent transurethral resection of prostate in X'an Aerospace General Hospital from January 2015 to December 2017 was performed.There were 14 cases of epididymitis and 338 cases of nonepididymitis.Measurement data were expressed as ((x) ± s),t test was used for comparison between groups;count data was expressed by rate (％),and chi-square test was used for comparison between groups.Univariate and multivariate logistic regression analyses were used for factors that may lead to post-urethral epididymitis.Results Univariate logistic regression analysis showed that preoperative leukocytic positive,urine glucose positive and prostate volume had significant effects on postoperative epididymitis (P ＜ 0.05).Multivariate logistic regression analysis showed that prostate volume increased (OR =0.182,P =0.005)was an independent risk factor for postoperative epididymitis.Conclusion The enlargement of prostate volume is an independent risk factor for postoperative epididymitis.For large-volume prostate surgery,the purpose of relieving obstruction can be achieved.

Objective To clarify the age patterns and types of differences so as to provide reference on prevention and interventions of hand,foot and mouth disease (HFMD) cases,in Hubei province.Methods We collected the HFMD case information of Hubei province from the Chinese National Notifiable Infectious Disease Reporting System in 2009-2015 while the information on pathogens from the laboratory monitoring system of Center for Disease Control and Prevention at all levels in Hubei province.All the data were stratified by age,disease severity,laboratory confirmation status,and serotypes of enterovirus.Results There were 495 783 reported HFMD cases from 2009 to 2015,in Hubei province,of which 1 045 were severe with 99 fatal.The annual notification rate was 1 231.0/106.HFMD cases were concentrated mainly in 0.5-5 year olds,with highest severity and mortality seen in 6-11 month-olds.The predominated pathogen in mild laboratory-confirmed cases each year,in order during 2009-2015 as:EV71,Cox A16,Cox A16,Cox A16,EV71,Cox A16 and other EV.HFMD showed semiannual peaks in April-June,November-December,and with more cases in the even years than in the odd years.Conclusions Children aged 0.5 to 5 years with 6 to 11 month-olds in particular,were the focused groups of attention in Hubei province.Our findings provided evidence for the improvement on monitoring program.Targeted intervention approaches should be strengthened to reduce the mortality and morbidity of HFMD in the province.