Objective To explore the effect of a phased rehabilitation training programme to relieve shoulder dys-function in patients after neck dissection and to provide effective solutions for postoperative shoulder joint function recov-ery of patients.Methods This study has been reviewed and approved by the Ethics Committee,and informed consent has been obtained from patients.A phased rehabilitaiton training programme for the shoulder after neck dessection was developed through literature review and discussion,and 70 eligible patients from Hospital of Stomatology,Sun Yat-sen University from December 2020 to April 2021 were selected and randomly divided into the test group and control group(35 patients in each group).The control group underwent motor rehabilitation training from 6 weeks postoperative to 1 year after surgery,such as shoulder mobility and coordination training and small range of motion training of the neck,while the test group took part in a rehabilitation training program that included familiarization maneuver training,protective rehabilitation,exercise rehabilitation,and resistance training in the following four stages:preoperative,postop-erative general anesthesia and awake until the removal of stitches,the removal of stitches until 6 weeks after surgery,and 6 weeks after surgery until 1 year after surgery.The frequency of training in both groups was at least 3 days per week,and the length of each training session was 10-15 min.The intensity of exercise was 2-3 points on the Borg Conscious Ex-ercise Intensity Scale(i.e.,mild-to-moderate tachypnea or fatigue).The neck dissection injury index(NDII)was used to evaluate the quality of life related to shoulder joint function at four time points:preoperative,postoperative 3 months,postoperative 6 months,and postoperative 12 months.The higher the score,the better the quality of life.Results 28 cases in the test group and 32 cases in the control group completed a one-year follow-up.At 3 and 6 months postopera-tive,the NDII of the test group was significantly higher than that of the control group[3 months postoperative:test group(93.48±9.36)vs.control group(80.00±11.34)(P＜0.001),6 months postoperative:test group(98.21±4.76)vs.control group(90.70±9.12)(P＜0.001)];12 months after surgery,the NDII of the test group(97.23±4.88)was still higher than that of the control group(96.33±4.49),but the difference was not statistically significant(P=0.458).The difference in NDII scores among subjects at 3,6,and 12 months after surgery was statistically significant in each group(P＜0.001).Conclusion The application of the phased rehabilitation training method in neck dissection patients has a feasibility and could improve the quality of life of patients'shoulder joint function within 6 months after surgery.

Objective:To investigate the effect of care bundles on prevention of nasal medical device-related pressure injury in patients with nasotracheal intubation undergoing oral and maxillofacial surgery under general anesthesia.Methods:This was a retrospective study. Using the convenient sampling method, patients with a surgical time more than 4 hours and a surgical grade of 3 or 4, with nasotracheal intubation undergoing oral and maxillofacial surgery under general anesthesia from Hospital of Stomatology, Sun Yat-sen University were selected. A total of 96 patients from July to December 2019 were in the control group, and 99 patients from July to December 2020 were selected as the observation group. The control group was treated with routine nursing measures, the observation group was subjected to a nursing care bundle. The incidence of nasal pressure injury was observed after the operation, 24, 48, 72 hours after the nasotracheal intubation was removed, and patients′ satisfaction score was compared.Results:The incidence of nasal pressure injury in the control group was 6.25% (6/96). None of the patients in the observation group had any pressure injury, which was significantly lower than the control group (Fisher exact probability method, P=0.013). The satisfaction scores in the observation group was significantly higher than that in the control group (26.88 ± 1.94 vs 24.71 ± 3.33), the difference was statistically significant ( t=-5.54, P<0.01). Conclusions:The care bundle can effectively prevent the occurrence of nasal pressure injury in patients undergoing oral and maxillofacial surgery with nasotracheal intubation and improve patient satisfaction.

Objective:To evaluate the clinical value of prenatal molecular diagnostic technology in preventing hereditary diseases through analysis of prenatal diagnostic characteristics in 22 monogenic skeletal disorders pedigrees.Methods:This study retrospectively analyzed prenatal molecular diagnostic results of 22 pedigrees with monogenic skeletal disorders who were admitted to Department of Osteoporosis and Bone Diseases in our hospital from January 2014 to July 2021.Results:Among 22 pedigrees, there were 10 pedigrees with X-linked hypophosphatemic rickets due to PHEX gene mutations, in which 8 fetuses were found to carry pathogenic variants; 6 pedigrees with osteopetrosis, including 3 cases of CLCN7 gene mutation, 2 TCIRG1 gene mutation, and 1 CTSK gene mutation, were detected to have 2 affected fetuses and 1 carrier. There were 4 cases of osteogenesis imperfecta, including 2 cases of COL1A1 gene mutation, 1 case of COL1A2 gene mutation, and 1 case of SERPINF1 gene mutation, in which 1 affected fetus and 1 carrier were found; only one case of osteoarthritis with mild chondrodysplasia caused by COL2A1 gene mutation was found to harbor pathogenic variant in fetus; 1 case of hypophosphatasia due to ALPL gene mutation was not detected to carry pathogenic variant in fetus. By the time of follow-up, all 12 affected fetuses were terminated, and the remaining 10 fetuses except for one case still in pregnancy were born in good condition.Conclusion:Prenatal molecular diagnosis may confirm whether the fetus carries pathogenic variants at the first and second trimesters. For monogenic skeletal disorders that comply with Mendel′s law of separation, prenatal diagnosis can be determined by calculating the probability of recurrence of offspring. In addition, for families with de novo mutations in the offspring, it is necessary to pay attention to whether there are mosaic mutations in the parents.

Objective:To investigate the situation related to HIV infection and influencing factors of traceability efficiency among sex partners of HIV positive men who have sex with men (MSM).Methods:A cross-sectional survey was conducted to investigate the traceability among sex partners of HIV-positive MSM in Ningbo from 2018 to 2020. Limiting-antigen avidity enzyme immunoassay determined recent HIV infection. The classified data was evaluated by chi-square test, and factors of traceability efficiency were analyzed by multivariate logistic regression.Results:A total of 374 newly confirmed HIV-positive MSM were recruited to participate in the HIV test in Ningbo from 2018 to 2020.HIV positive rate of sex partner was 15.7% (75/479,95% CI:12.4%-18.9%). HIV positive rates of sex partner of recent HIV infection MSM was 31.8% (21/66,95% CI:20.3%-43.4%). The proportion of newly confirmed HIV-positive sex partners of recent HIV infection MSM (76.2%) was higher than that of long-term HIV infection MSM (48.1%). The difference was statistically significant ( P=0.028). Results from the multivariate logistic regression analysis showed that HIV traceability efficiency was higher in the following subpopulations as; HIV positive MSM who were 36-45 years old (compared with 18-25 years old, OR=3.973,95% CI:1.364-11.569), HIV active detection (compared with HIV passive detection, OR=1.896, 95% CI:1.083-3.319), recent HIV infection MSM (compared with long-term HIV infection MSM, OR=3.733, 95% CI:1.844-7.556). Conclusions:HIV positive rate among partners of HIV positive MSM was very high. The traceability efficiency, which was recent HIV infection MSM and HIV active detection, was high. It is suggested to strengthen the traceability and focus on the newly confirmed HIV-positive MSM in VCT clinics.

Objective:To explore the effect of Teach-Back model on oral health behavior among the middle-aged and aged.Methods:From March 2017 to June 2018, 150 middle-aged and elderly patients undergoing oral examinations from the Department of Preventive Dentistry, Hospital of Stomatology, Sun Yat-sen University were selected as the survey subject by convenience sampling. Patients were divided into experimental group ( n=70) and control group ( n=80) . Control group was given regular oral health guidance, and experimental group implemented Teach-Back nursing care on the basis of control group. After 6 months of intervention, we compared the cognition of periodontal disease, oral health behavior, and periodontal health status of middle-aged and elderly patients between two groups. Results:After 6 months of intervention, the scores of daily oral hygiene habits, periodontal disease cognition and periodontal disease treatment behavior of experimental group were higher than those of control group, and the differences were statistically significant ( P<0.05) . The Debris Index-Simplified (DI-S) , Calculus Index-Simplified (CI-S) , Gingival Index (GI) , Bleeing Index (BI) and Depth of Periodontal Pocket (PD) of experimental group were lower than those of control group with statistical differences ( P<0.05) . Conclusions:Middle-aged and elderly people have poor periodontal disease cognition and need nursing intervention. Teach-Back model can improve the daily oral hygiene habits of middle-aged and elderly patients, improve their correct understanding of periodontal disease, and improve their oral health behavior and quality of life.

Objective To investigate the effects of plaque staining test on periodontal health of middle-aged and elderly patients with dental implants. Methods Ninety patients with dental implants were included in the study and divided into test group (n=45) and control group (n=45) by using random digit table. In the test group, the patients were all instructed with both routine health education and dental plaque dyeing education, while the control group received routine health education only. The plaque index (PLI) and gingival index (GI) were assessed at months 1 and 6 after implant restoration. Results One month after dental implantation, there were no significant differences in PLI and GI between the two groups (P>0.05), while 6 months after the implantation, the differences in PLI and GI between them were significantly different ( P<0 . 01 ) . Conclusion The plaque dyeing technology applied in the oral health education to elderly patients with dental implants can reduce plaque index and gingival index so that their periodontal health is enhanced.

ObjectiveTo discuss two fixation methods of nasotracheal intubation on the occurrence of nasal pressure sores in patients with maxillofacial surgery.MethodsThree hundred cases of patients under general anesthesia more than 4 hours with the nasal endotracheal intubation were randomly assigned into control group and experiment group with 150 cases in each group.In control group,medical tape was used to fix the endotracheal tube to dorsum,wrapping around the joint of endotracheal tube and threaded pipe.In experiment group,Mepilex foam dressing was used to wrap over the bend of endotracheal tube,with gauze covering the joint of endotracheal tube and threaded pipe before fixing the endotracheal tube to dorsum.Finally,the occurrence of pressure sores from the end of surgery to postoperative 1day were compared between the two groups.ResultsThe incidence of patients with first stage pressure sores was 4.7% in control group while none in experiment group.The incidence of nasal pressure sores was much lower in experiment group than that in control group (P<0.05).ConclusionsThe use of Mepilex foam dressing can reduce the pressure and friction between the endotracheal tube and the dorsum,which effectively prevents nasal pressure sores caused by endotracheal intubation.Therefore when having surgery with nasal general anesthesia and nasotracheal intubation and lastsing over 4 hours,the use of application covering the bend of endotracheal tube can prevent nasal pressure sores.

In this study ,we analyzed the genetic characterizations and propagation paths of measles viruses prevalent in Ningbo ,China from 2004 to 2013 .Measles viruses were isolated from throat swab specimens from 2004 to 2013 ,and 450 bp fragments of C terminus of nucleoprotein (N) gene were amplified by RT-PCR .Sequence analysis was conducted of all 31 virus strains ,and then compared with other measles virus strains published in GenBank .Results showed that all the 31 measles virus isolates belonged to genotype H1 ,6 strains (one strains in 2004 and 5 ones in 2005) belonged to H1b subtype ,and others be-longed to H1a subtype .Compared the 31 strains to the China 93-4 and China 94-7 ,the homology of 450 bp fragments of C ter-minus of nucleoprotein (N) gene were 97 .1%-100% and 96 .7%-100% ,respectively .The homology of 450 bp fragments of nu-cleotide and nucleotide (amino acids) compared with S191 were 81 .9%-92 .4% and 87 .2%-90 .6% ,respectively .It’s suggested that genotype H1 measles virus circulated in Ningbo from 2004 to 2013 ,and H1a was the predominant epidemic strain ,and H1b strain was existed as well .There are five different transmission chains of H1a subtype caused measles co-circulations in Ning-bo .

Objective To discuss failure mode and effects analysis (FMEA) in reducing the surgical patient’s postoperative indwelling pathologic specimens error rate and effective control of the specimen quality inspection application .Methods We established the FMEA team and set “reduce postoperative indwelling pathologic specimen error rate” as the theme.According to the process of drawing , analysis, calculation of risk assessment code (RAC) and risk priority number (RPN), evaluation the results, etc, we investigated all the postoperative indwelling pathologic specimen situations and analyzed the cause of error specimen lien .Then corresponding countermeasures were made and applied .At last, we checked the effect .Results After the implementation of FMEA , the postoperative indwelling pathologic specimen error rate for the surgical patients decreased from 13.11% to 0.00%.Conclusions FMEA is very effective in reducing the surgical patient ’ s postoperative indwelling pathologic specimens risk and is worthy of generalizing .

Objective To investigate the risk factors for osteoporosis (OP) in aged people at Beicai Town in Shanghai, to provide proofs for preventing OP. Methods Questionnaire survey was carried out on bone density in 608 aged people (aged from 60 to 79 years) who were randomly chosen from 4 resident committees of Beicai Town in Shanghai. Everyone underwent bone mineral density (BMD) assay of lumbar spine and total hip by DEXA machine. Results The rate of OP was 23 % in male group, and 61% in female group. It was 40% in 60-64 years old group, 44% in 65-69 years old group, 53% in 70-74 years old group and 66% in 75-79 years old group. The rate of OP was 52% in manual work group, and 42 % in non-manual work group. In males, it was 54 % in current weight less than 60 kg group, 19% in 60-70 kg group, 15% in 70-80 kg group and 23% in over 80 kg group. In females, it was 76% in current weight less than 50 kg group, 67% in 50-60 kg group, 63% in 60-70kg group, 30% in over 70 kg group. It was 56% in low body weight group, 41% in normal weight group and 58% in over weight group in their 25-year-old. It was 61% in normal body weight group, 43% in overweight group. It was 41% in non-fracture history group, 67% in once fracture group,74% in fracture history more than twice group. It was 60% in mother humpback history group, and 47% in no history of mother humpback group. Logistic regression analysis showed that gender, age,history of fracture, mother's humpbacked history, disease of internal secretion and metabolism system were the risk factors for OP. Conclusions The occurrence of OP is related with many factors in aged people at Beicai Town in Shanghai, especially for the aged women, who suffer from diseases of internal secretion and metabolism, and has the history of fracture and mother's humpbacked, the attention should be payed to the prevention and treatment of OP.