In tracheal resection and reconstruction, a technically demanding, complex, and high-risk procedure, management of the anastomotic site significantly impacts postoperative outcomes and long-term quality of life. However, comprehensive studies detailing perioperative anastomotic management strategies in tracheal reconstruction remain scarce. This review summarizes perioperative management strategies for tracheal reconstruction, covering preoperative assessment, surgical techniques, and other key aspects. It also highlights future research directions and challenges, aiming to provide clinicians with a systematic guide to perioperative management in tracheal reconstruction.

Modern medical model advocates holistic medical treatment and holistic care, which transforms the concern about diseases in traditional medicine into the concern about people in modern medicine. Narrative medicine, as a tool for practicing holistic medical treatment and holistic care, runs through the whole process of patients’ entering medical procedures. It not only meets the needs of patients’ disease-related narratives, but also provides a new and more comprehensive way of communication for both doctors and patients, which is helpful to promote the comprehensive recovery of patients and the healthy development of doctor-patient relationship. At present, narrative medicine is facing some difficulties in the process of local practice in China. Social work, as one of the main bodies of multi-disciplinary and inter-professional cooperation in the medical field, can give full play to its professional advantages to help the new exploration of narrative medicine practice in China.

Objective To investigate the potential medication risk by identifying and analyzing the features of liver-related adverse drug reaction (ADR) in pregnant women. Methods A retrospective study was performed for the reports on liver-related ADR in pregnant women from January 1, 2012 to December 31, 2016 in HILI Cloud (hilicloud.net). Main clinical features and medication rules were analyzed, and reporting odds ratio ( ROR ) was used to analyze the relative risk of related drugs. Results Methotrexate, mifepristone, and ritodrine were the high-frequency drugs reported for liver-related ADR in pregnant women and were mainly used for termination of ectopic pregnancy and treatment of hydatidiform mole. The relative risk analysis of liver-related ADR showed that in pregnant women, the use of methotrexate ( ROR =37.52, 95% confidence interval [ CI ]=31.35-44.89), progesterone ( ROR =7.33, 95% CI : 2.75-19.59), and dydrogesterone ( ROR =6.58, 95% CI : 2.20-19.69) was strongly associated with the risk of liver injury, and the association of methotrexate with the risk of liver injury in pregnant women was significantly stronger than that in non-pregnant women ( ROR =1.71, 95% CI : 1.47-4.36). Conclusion The potential risk of liver injury should be taken seriously in pregnant women using the drugs such as methotrexate and progesterone, so as to avoid serious adverse reactions.

The tumors of central nervous system refer to a group of benign and malignant diseases originating from tissues or structures within the central nervous system. Common tumors of central nervous system are sporadic, but a few have familial onset. Compared with sporadic brain tumors, the clinical symptoms, diagnostic ideas and follow-up review plans of familial brain tumors are more complicated. The multidisciplinary diagnosis and treatment (MDT) mode usually refers to a treatment mode in which a case involving multiple organs and systems is discussed, and the best treatment plan is formulated for the patient based on the comprehensive opinions of various disciplines. Because familial brain tumors often involve multiple organs, multiple disciplines and multiple systems, and their low incidence leads to less clinical experience for neurosurgeons, the MDT model is more conducive to efficient diagnosis, treatment and management of familial brain tumors. This review elaborates on the neurosurgeon-led MDT model, and introduces the latest research on the epidemiology, genetic characteristics, clinical manifestations, diagnostic ideas and multidisciplinary management of familial brain tumors.

Objective: To investigate the correlation between age-related hearing loss and cognitive impairment. Methods: 201 elderly patients, who were admitted to the Department of Otorhinolaryngology of Peking University People′s Hospital from March 1, 2017 to March 31, 2017, were evaluated with hearing screening and the Montreal Cognitive Assessment Scale. Among them, 101 were female and 100 were male, aged 60-90 years old. Taking the cognitive level as the dependent variable, and taking the age, sex, education, occupation, marital status, residence, and average hearing loss (average hearing threshold of 500, 1 000, 2 000, and 4 000 Hz), as well as the length of conscious hearing loss as the independent variables, the single factor analysis and multivariate linear regression analysis were used to screen the main factors affecting the cognitive level of the elderly. Results: Of the 201 elderly patients, 39 had normal hearing, 65 had mild hearing loss, 80 had moderate hearing loss, 16 had severe hearing loss, and 1 had profound hearing loss. The average degree of hearing loss was the influencing factor of cognitive impairment, and it mainly affected the directional force and abstract ability in the cognitive domains (P<0.05); The age, self-reported hearing loss, years of education, marital status, past ear diseases, and hypertension were relatively independent factors that affected the cognitive level(P<0.05). Conclusions Age-related hearing loss is the risk factor for the cognitive impairment, especially for abstraction and orientation, in the elderly. The self-reported hearing loss is an independent risk factor for cognitive impairment.

Objective The incidence rate of pressure ulcer is high in critical patients and off-loading mattresses and reposi-tioning are known as effective interventions for the prevention of pressure ulcers .However, evidence is lacking for selection of the right type of mattresses and suitable interval of repositioning .This study was to compare the effects of two types of off-loading mattresses with two different repositioning intervals in preventing pressure ulcers in critical patients . Methods According to the design of this ran-domized controlled trial , we made a training plan concerning the participants , methods of intervention and comparison , criteria and methods of observation , and methods of recording , and trained 26 nurses from 7 hospitals .Using non-inferiority design and the method of stratified blocked randomization , we divided 1194 patients with the risk of pressure ulcer into a trial group ( n=596) and a control group ( n=598) , a viscoelastic sponge mattress with every-four-hours repositioning used for the former and an automatic aeration mat-tress with every-two-hours repositioning for the latter , both for 7 successive days .We examined the patients every day , recorded the in-cidence and stages of pressure ulcer , and compared the data obtained between the two groups of patients . Results The total inci-dence rate of pressure ulcer was 1.09%(13/1194), significantly lower in the trial than in the control group (0.34%[2/596] vs 1.84%[11/598], P=0.012). Conclusion A viscoelastic sponge mattress with every-four-hours repositioning is superior to an automatic aeration mattress with every-two-hours repositioning and therefore is preferred to the latter in preventing the incidence of pressure ulcer in critical patients in the ICU .

Objective To explore the effects of DPP-4 inhibitor sitagliptin on insulitis of NOD mice and the potential mechanism. Methods 223-month-old female NOD mice were randomly divided into Sitagliptin(Si-ta)group(n=11)gavaged with Sita(30 mg/Kg)daily for 12 weeks and control(Con)group with equal volume of normal saline(NS). The body weight,food-intake,water-intake and blood glucose were recorded weekly. Intraperi-toneal glucose tolerance test(IPGTT)was performed at the end of treatment and the blood sample was collected. Then mice were execute. The serum insulin level was measured by ELISA. Pancreas morphology and insulitis were evaluated by hematoxylin-eosin staining. The protein expression level of TLR4 ,MyD88 and NF-κB was analyzed by Western Blot. Results Compared with that of Con group ,the insulitis of Sita group was significantly alleviative(P < 0.05)and the serum insulin level was increased significantly(P < 0.05). The protein expression level of TLR4(P<0.05),MyD88(P<0.01)and NF-κB(P<0.05)in Sita group was significantly decreased. Conclusion Sitagliptin alleviates insulitis in NOD mice and increases the serum insulin level ,probably owing to the suppression of TLR4/MyD88/NF-κB signaling pathway.

Objective: To study the clinical features and treatment of children with influenza, and provide evidence for clinical screening and appropriate treatment timely. Methods: Epidemiology, clinical manifestations, laboratory features and drug therapy of 978 pediatric patients with influenza in Beijing New Century International Children's Hospital in 2014 were analyzed retrospectively. Results: Among the 978 pediatric patients with influenza, 90.8%were outpatients, while 9.92% were inpatients. The incidence was the highest in winter (85.28%). The age of most cases ranged from 1 to 5 years (57.16%). The cases with type A influenza accounted for 81.29%. High fever (99.59%) and cough (85.89%) were the two main symptoms. The average count of WBC was 6.86±2.68×10⁹/L, lymphocyte percentage was lower than the proportion of neutrophils. CRP was normal (66.16%) or slightly-increased (19.00± 15.12 mg/l). Compared with type A influenza, digestive tract symptoms were more common in cases with type B (P=0.000). Analysis of 97 hospitalized cases: the main diagnosis was lower respiratory tract infection (71.13%). Nearly 23.71% cases had been detected to have combined infection with other pathogenic agents. Course of fever in cases who started taking oseltamivir after fever of 48 hours was significantly longer than those who took within 48 hours (P=0.000). Seven severe pneumonia cases were mainly in young children, cases with underlying disease or mixed infection, they were all cured by active and comprehensive therapy. Conclusions Influenza in children is characterized by high fever and cough, digestive tract symptoms frequently occurred in patients with type B influenza. Early application of oseltamivir could signficantly shorten the period of fever. Severe cases should be given active and comprehensive treatments.

Objective:To explore influence of health education on quality of life and compliance in community pa‐tients with coronary heart disease (CHD) .Methods :A total of 83 community CHD patients were selected and ran‐domly divided into routine treatment group (n=38 ,received routine treatment of CHD ) and health education group (n=45 ,received CHD health education based on routine treatment ) .Score of Seattle angina questionnaire (SAQ) after intervention ,therapeutic compliance and incidence rate of major adverse cardiovascular events (MACE) with‐in six months were compared between two groups .Results:Compared with routine treatment group after interven‐tion ,there were significant rise in each item score and total score of SAQ [total score ,(54.3 ± 7.2) scores vs .(65.4 ± 7.5) scores] ,P<0.05 all;and therapeutic compliance also significantly rose (good rate ,52.6% vs .77.8% ) in health education group , P< 0.05. After six‐month follow‐up ,total incidence rate of MACE in health education group was significantly lower than that of routine treatment group (8.9% vs .26.3% ) , P< 0.05. Conclusion:Health education can significantly improve quality of life ,compliance and prognosis in community patients with cor‐onary heart disease ,which is worth clinical extending and use .

Objective To investigate the quality of life of patients with chronic diseases as well as the influencing factors. Method Two hundred and fifty five elderly patients with chronic disease from 3 hospitals in Guangzhou involved in the survey by adopting WHO quality of life-old(WHO OQOL-OLD)to investigate the quality of life and influencial factors.Results The quality of life of the elderly patients was in middle level.In the dimension of Past,Present and Future Activities,the quality of life was statistically different between the patients with different chronic diseases(P<0.05);In the dimension of Autonomy and Death&Dying, the quality of life was statistically different between those with and without cerebrovascular diseaseor(all P<0.05);In the dimensions of Autonomy,Social Participation,Death and Dying and Intimacy,the quality of life was statistically different between those needing care and no care after discharge(all P<0.05).Conclusions The quality of life of the elderly patients with chronic diseases is in middle level.The influencing factors for the quality of life include contracting multiple diseases,needing care after discharge and cerebrovascular diseases.At discharge,nurses should regulate instructions for them for the purpose of improving their autonomy,social participation and adaptability after discharge. Thus,their quality of life can be improved.